Is Health Insurance on your School Supplies List?

Parents, as you begin prepping your kids for the end of summer and the return to school, make sure health insurance is included on their school supplies list.

Health insurance coverage is an important part of making sure kids do well in school. It can pay for vaccinations, prescription drugs, sick visits, and regular check-ups. These services add up to kids going to school healthier and ready to learn.

Uninsured kids (and their parents/caretakers) may be able to access health insurance through BadgerCare Plus or the Health Insurance Marketplace, depending on their income. A family of four with income under $24,250 year can all be insured through BadgerCare Plus. A family of four with income under $95,4000 is insurable (with tax credits to help pay for the cost) through the Health Insurance Marketplace.

Generally, people have to apply for health insurance during the Open Enrollment period which begins November 1st of this year. However, families who have experienced qualifying events, like marriage, birth, job loss or moves may be able to apply through a Special Enrollment Period. And, people eligible for BadgerCare Plus can apply anytime they are eligible throughout the year.

Consumers can check and see if they are eligible and apply online for health insurance coverage at www.healthcare.gov, call the Health Insurance Marketplace at 1-800-318-2596, or contact a local Navigator or enrollment assister to talk through their options face-to-face.

Call Covering Kids & Families for more information and to apply; Milwaukee, 414-270-4677 or Madison, 608-261-1455. For other local enrollment assistance sites, dial 2-1-1 or visit https://localhelp.healthcare.gov/.

Wisconsin Residents at Risk for Losing Tax Credits

The Issue

As many as 1.8 million consumers nationwide are at risk of losing tax credits and paying more for coverage selected through the Health Insurance Marketplace.

In 2014, 4.5 million consumers nationwide claimed tax credits to reduce the cost of their health insurance purchased through the Marketplace. In Wisconsin, 166,142 individuals or 90 percent of those who enrolled received a tax credit. Those who used advanced payments of the tax credit to lower their monthly premiums were also required to file a federal tax return to verify their income. However, many consumers have not completed this step. Those who have not filed taxes could be disqualified from receiving tax credits for the upcoming year and be asked to pay back their tax credits for 2014.

In order to be eligible for the premium tax credit used to reduce the cost of health insurance coverage through the Marketplace, consumers are required to file taxes. A letter released by the IRS Commissioner cites that throughout the country, 710,000 consumers have not filed their taxes or requested an extension, 760,000 need to send in additional paperwork, and 360,000 filed an extension, but still need to complete their returns. There is not yet data available specific to the number of Wisconsin residents who are affected.

What Consumers Need to Know

If you had a Marketplace plan in 2014 and used advance payments of the premium tax credit to lower your monthly premiums, you must file a federal income tax return. If you haven’t filed yet, you should do it as soon as possible. If you haven’t filed a 2014 tax return, you may get a letter from the IRS.

  • You must file even if you haven’t filed for an extension.
  • You must file even if you usually don’t.
  • If you don’t file a 2014 return, you may not be able to get a premium tax credit for a 2016 plan. You’d have to pay the full cost for a Marketplace health plan.

Consumers who have not filed their taxes or sent in the required forms need to do so as soon as possible or they may be ineligible to receive tax credits beginning January 1, 2016. Consumers interested in maintaining coverage would then be responsible for paying the full premiums for their health insurance. The average monthly premium (without any tax credits applied) in Wisconsin was $450 this year.

To avoid being uninsured or paying more for their coverage, consumers should file their 2014 taxes immediately. Consumers will need form 1095-A to file their taxes, which can be downloaded from their Marketplace account at www.healthcare.gov. Consumers who originally applied for coverage by phone should contact the Marketplace Call Center to request a copy of the form at 1-800-318-2596. When Form 1095-A is received, consumers should file their taxes either online or through a local tax preparer agency (find one here). Consumers with tax filing questions can contact the IRS or reference their website for more information.

Happy 50th Anniversary Medicare and Medicaid!

July 30th, 2015 marks the 50th anniversary of the national Medicaid and Medicare programs, signed into law by President Johnson in 1965. Those programs’ initial expansions of health coverage to the poor and elderly began a decade-long decline in the national uninsured rate, as many people who had previously been uninsured gradually enrolled in coverage.

Asthe Kaiser Foundation writes (1), the authors of the 1965 law “could not have predicted that that federal and state policymakers would look to the program again and again to cover the growing number of uninsured and underinsured Americans, or that it would become the nation’s de facto long-term care program for people with disabilities and senior citizens, or that it would be a major source of health care financing and innovation (our emphasis).”

We often take Medicaid and Medicare for granted today, but they play essential roles in making the American health care system accessible to the poor, elderly, and disabled. A look at changes in the national uninsured rate (below and in more detail here (2)) serves as a reminder that, after bill became law, these programs’ expansions of benefits happened over years, not overnight.

uninsured rate from 1960

The graph above also shows a gradual decrease in uninsured rates beginning with passage of the Affordable Care Act in 2010, the first sustained expansion of health coverage since 1975. The Health Insurance Marketplace and recent changes to BadgerCare Plus (3) are expanding health care access in Wisconsin, as did Medicaid (4) and Medicare (5). Also like the changes 50 years ago, today’s changes are taking time.

Many have already taken advantage of the ACA’s new coverage opportunities. Women and those with pre-existing conditions can now purchase coverage for the same price as everyone else, young adults can stay insured through their parents until age 26, and many have found affordable insurance on the Marketplace.
The ACA also provides opportunities to get and stay covered that are less well-known. Individuals who leave a job or start a new one can apply for Marketplace insurance, even outside of Open Enrollment. Couples getting married or divorced, individuals moving outside their current plan’s coverage area, and others who are going through times of transition can access the Marketplace throughout the year. Employers may also be able to attract employees by offering coverage through healthcare.gov’s Marketplace for small businesses, which also has subsidies available.

Finally, the ACA established funding for Navigators, who help consumers sort through all the resources that are available. Navigator services are a free, public resource and available year-round. Contact a Navigator at Covering Kids and Families to ask questions or make an appointment to enroll in coverage.

Here is an infographic to celebrate the day:

Medicaid-Medicare 50th Anniversary

Move into Health Insurance!

July is one of the most popular months for people to move. Although moving to a new area can be stressful and chaotic, it may also provide consumers the opportunity to gain some peace of mind by accessing health insurance coverage.

Though the Health Insurance Marketplace’s Open Enrollment period closed in February, there are a number of special qualifying life events that allow people a chance to enroll or change their coverage throughout the year – and changing zip codes is one of them.

“Consumers who switch jobs and cities of residence may no longer have the same health insurance options as they did back home. Since a change in zip code is considered a qualifying life event, movers will have 60 days to apply for new coverage,” says licensed Navigator Caroline Gomez-Tom. “Sixty days still provides plenty of time to unpack, arrange the furniture and enroll your family in health insurance coverage!”

Consumers can apply online for health insurance coverage at healthcare.gov, call the Health Insurance Marketplace 1-800-318-2596, or contact a local Navigator or enrollment assister to talk through their options face-to-face.

Call Covering Kids & Families for more information and to apply; Milwaukee, 414-270-4677 or Madison 608-261-1455.  For other local enrollment assistance sites, dial 2-1-1 or visit https://localhelp.healthcare.gov/.

King V. Burwell Decision: ACA Tax Credits Are Here To Stay In Wisconsin

Image credited to Huffington Post Sam Stein

Image credited to HuffPost Sam Stein

Today, June 25, 2015, the Supreme Court of the United States ruled on the court case King V. Burwell in favor of Burwell. The outcome of this case confirms the use of advance premium tax credits for consumers using a state exchange or the federal Health Insurance Marketplace (www.healthcare.gov). The Supreme Court decided that Congress’ intention was to make financial assistance available to all consumers regardless of the state they live in, or whether their state made the decision to create their own Marketplace.

This decision allows over 166,000 Wisconsin residents to continue receiving their federal financial subsidies for their health insurance through the Marketplace and continues to provide the access to future tax credits and financial assistance to people who may still be uninsured.

Consumers can dial 2-1-1 to find a local enrollment assister, and also contact the Marketplace Call Center at 1-800-318-2596 to enroll in coverage. There are many Navigator and Certified Application Counselors across the state that are ready to answer questions and help people access health insurance.  Consumers in the Milwaukee area can call 414-270-4677 and 608-261-1455 in the Madison area to speak with a local Navigator.

School is Out, but Health Insurance is Always In!

Children all over Wisconsin are crouched in their seats, counting down the final seconds until 3:00, spring-loaded to dash out the door for the last time until fall. For many, the last day of school signals the beginning of summer and several months largely free of responsibility.

After taking a few moments to reminisce about care-free memories such as these, many adults reawaken to the reality that summer means employment change, and a laundry list of budget items to attend to. Remember that employment changes often affect health insurance. As summer begins and many readjust their budgets, remind your friends and family to keep their insurance up to date!

The end of school alone has far reaching effects on employment. As children wake up to cartoons and camps instead of last-minute dashes to the curb, many bus drivers switch jobs or begin receiving unemployment insurance for the summer months. Sick teachers no longer require substitutes, and kitchen staff abandon lunch rooms, now eerily quiet in the absence of rambunctious, ravenous youngsters.

Many people who do not work in schools also face employment changes in the summertime. As children run off to summer camps and public pools, park staff and camp counselors may switch from part- to full-time employment or drop supplemental positions. Construction workers, plumbers, and electricians may find seasonal work renovating school facilities while the halls are empty. Gardeners and landscapers may find their services suddenly in high-demand.

Regardless of the specifics, any income or job change can affect a person’s health insurance options, especially for those insured through the Health Insurance Marketplace (www.healthcare.gov) or Badgercare Plus. People experiencing an income change should remember to update their information on their Marketplace or Access application, since changing income will affect subsidy amounts and, potentially, eligibility for Badgercare Plus.

Those who transition between full- and part-time employment may gain or lose an offer of employer health coverage. These offers can also affect eligibility for the premium tax credit and should be reported as soon as possible. It is important for consumers to remember their responsibility to keep marketplace application information accurate and current.

Of course, health insurance may take low priority in planning a budget, especially in light of more pressing budget items like food and utility bills. Without a doubt, it can be annoying to have to report changes to the Marketplace throughout the year. But especially for seasonal workers whose incomes change regularly, a single meeting with a Navigator or other enrollment assister can help consumers plan to stay covered for the whole year. A Navigator can help consumers determine what (and whose) income to report, estimate a yearly total, and develop a plan to stay covered all year. Consumers can dial 2-1-1 to find a local enrollment assister, and also contact the Marketplace Call Center at 1-800-318-2596 to make changes or ask questions.

By accurately reporting their financial situation for the whole year, seasonal workers can remove one concern from an often too-full plate during times of transition. Encourage those you know to plan ahead now to stay insured for the rest of the year. That way, when August rolls around and children are fretting over their back-to-school preparations, these hard-working adults can enjoy a turn to feel care-free.

Dial 2-1-1 to find local enrollment assistance, the Marketplace Call Center at 1-800-318-2596, or contact Covering Kids and Families for a Navigator:

Milwaukee: 414-270-4677

Racine/Kenosha: 262-637-8377

Rock/Walworth: 262-902-8572

Dane: 608-261-1455

Understand your health insurance… and be prepared for next year!

Since the Health Insurance Marketplace went online, much work has been devoted to getting people without insurance enrolled in a plan. But once you have new health insurance, it is equally important to make sure you stay insured and are considering your full range of options. If you enrolled in Marketplace coverage for 2015, keep the following questions in mind throughout the year:

Has my household’s income changed since I filled out my Marketplace application?

If you have Marketplace health insurance and are receiving tax credits to help pay your monthly premium, remember that the amount you are receiving is based on your estimate of your 2015 yearly income. This is the amount that you reported on your Marketplace application.

It is important to log on to healthcare.gov and report changes whenever you experience an income or household change. Changes that need to be reported include an increase or decrease in how much you get paid or how many dependents you have, as well as a change in marital status. Updating your information on healthcare.gov will allow any financial assistance you receive to be corrected for your next month’s premium, which can help prevent you from having to pay back tax credits when you file your taxes next spring.

Is my current plan helping me meet my health needs affordably?

Keep in mind that the Marketplace, as well as many employers, offers a variety of insurance options each year. If you suspect that your current coverage may not be the best fit for you, reach out to a navigator or other in-person assister about exploring other options. Unless you have an income or household change, you usually cannot switch your insurance plan mid-year, but most insurance providers (including Marketplace, Medicare, and many employer options) WILL allow you to switch plans each fall.

How long will my current insurance plan continue?

If you have Marketplace insurance, your current plan will continue until the end of the year (December 31, 2015). At that point, the insurance company may decide to change your plan’s costs or benefits, or your plan may stay the same. Your insurance company will send you a letter this fall about any changes that will go into effect on January 1st.

Keep in mind that other plans may change as well, and entirely new plans may be offered. It benefits you to re-examine options in the Marketplace each year. If you have employer coverage and think it may be unaffordable, the Marketplace may be an option for you as well. Beginning on November 1st, you can check out the Marketplace options for the coming year. If you decide to switch, make sure to enroll by December 15th for your new coverage to begin on January 1st. You will have the entire open enrollment period (November 1, 2015 – January 31, 2016) to change plans, though.

I know someone who still does not have any health insurance. When can they apply?

The best time of year to apply is in the fall, when most insurance options have open enrollment periods. But someone who needs insurance now may have other options. People who experience a qualifying life change may qualify for a Special Enrollment Period, and if your income makes you eligible for BadgerCare Plus, you can sign up at any time through the state website. See below for a summary of when to apply through the Marketplace.

fig for SEP post version2

**Apply for BadgerCare Plus at any time**

If you have any questions about your eligibility, reporting changes, or making sure you are considering all your options, call one of the Navigator agencies below to get free, local help:

Madison: Covering Kids & Families – 608-261-1455
Milwaukee: Covering Kids & Families – 414-270-4677 and Gerald Ignace Tribal Health Center – 414-383-9526
Racine & Kenosha: Racine Kenosha Community Action Agency – 262-637-8377
Janesville: First Choice Women’s Health Center – 262-902-8572
Dial 2-1-1 anywhere in Wisconsin to find in-person enrollment help in your area.

Say “I do” to Health Insurance Coverage!

The beginning of May brings flowers, warmer weather, and the kick off to wedding season.  Do you know anyone getting married this summer?  In addition to picking out a present on their registry, why not also share the gift of health insurance?

Although the Health Insurance Marketplace’s Open Enrollment period closed in February, there are a number of special qualifying events that allow people a chance to enroll or change their coverage throughout the year – and marriage is one of them.  As your friends and family members are planning their vows and heading to their county clerks’ offices for their marriage certificates, remind them to add applying for health insurance to their list of to-dos.

Because marriage is considered a qualifying event, lucky couples will have 60 days from their I-do’s to apply, which is still plenty of time for a honeymoon! The process for changing or applying for new coverage is fairly straightforward, so don’t worry about causing the newlyweds any stress.  The couple can apply online at healthcare.gov, call the Health Insurance Marketplace 1-800-318-2596, or contact a local Navigator or enrollment assister to talk through their options face-to-face.

Now the newlyweds may be concerned about cost, especially after paying for all of the other expenses that go along with getting married.  So remind them that in Wisconsin last year, over 80% of people were eligible for coverage costing less than $100 per month.  That coverage includes doctors’ visits, prescription drugs, hospital services and all the other major benefits needed “in sickness and in health.”

As we kick off the wedding season this month, remember that health insurance coverage could be a very affordable and important addition to a new family!  Call Covering Kids & Families for more information and to apply: Milwaukee: 414-270-4677, Madison and surrounding counties: 608-261-1455, Racine/Kenosha: 262-637-8377, and Rock/Walworth: 262-902-8572.

For other local enrollment assistance sites, dial 2-1-1 or visit https://localhelp.healthcare.gov/.

Ready for Health Insurance Enrollment Super Saturday on January 31?

With just 18 days to go before the Affordable Care Act’s Health Insurance Marketplace open enrollment period closes on February 15, community organizations, enrollment assisters, and insurance agents are planning nearly two dozen insurance enrollment events around Wisconsin on Saturday, January 31.

Consumers can drop in at any of these events to ask questions about eligibility for Marketplace or BadgerCare Plus insurance, learn about insurance or enroll.

With a few exceptions, US and legally documented immigrants must now have health insurance or may have to pay a tax fine that goes up every year. On the Marketplace, plans range in costs and services to help fit into your budget and meet your actual health care needs. And, 90% of people in Wisconsin have been able to take advantage of tax credits to reduce the cost of premiums, and some financially eligible households have been able to reduce their out-of-pocket costs to just few dollars per doctor visit. Health insurance is a big decision and it can be complicated. That is why CKF is here to help, on Super Saturday and throughout the year.

The Southern Wisconsin Navigator Collaborative (Covering Kids & Families, Gerald Ignace Tribal Health Center, Southwest Community Action Program and Racine Kenosha Community Action Agency) has 7 events planned on Super Saturday.

Milwaukee
Center Street Library
2727 W. Fond du Lac Ave
10 am to 2 pm

Journey House
2110 W. Scott St.
10 am to 1 pm

La Murguia Head Start building
1645 S. 36th St.
Noon to 3 pm

CVS Pharmacy (Molina)
2607 N. Downer Ave.
2 pm to 6 pm
Dial 2-1-1 or 414-270-4677 for details.

Madison (Press Release)
United Way of Dane County
2059 Atwood Ave.
9 am to 6 pm
Dial 2-1-1 or 608-261-1455 for details or to set up an appointment.

Racine
Racine County Human Services/Workforce Development Center
1717 Taylor Ave.
Noon to 3 pm
Contact: Jessica Retzlaff
jretzlaff@kenoshachc.org

Dodgeville
Southwest Technical College Outreach Center Computer Lab (Piggly Wiggly Mall)
316 W. Spring St.
9 am to 1 pm

If your clients, friends and family who need insurance aren’t near these events, learn about a dozen more in the state at the EnrollWI Website http://enrollwi.org/events/2015-01-31/.

The Affordable Care Act may affect your taxes this year! Be ready to file in ’14 and fix it for ’15.

With the New Year begun and tax season underway, Wisconsinites may be surprised to find a new line on their tax forms asking about their health coverage. As of January 1st, 2014, those who do not have health coverage may have to pay a penalty at tax time. The IRS will assess the first year’s penalties on consumers’ tax returns this spring.

Consumers who have health insurance (like through an employer or a relative) will simply check a box on their taxes this year indicating that they were insured for 2014.

The changes will be more involved for consumers who bought 2014 coverage through the Health Insurance Marketplace and received the Advanced Premium Tax Credit (APTC), and for those who were uninsured last year.

Consumers with Marketplace coverage will need to complete new forms to reconcile the tax credits they received. The tax credits were based on estimated 2014 income, and now they must be corrected to reflect what consumers actually ended up making. These consumers should be on the lookout for Form 1095-A in the mail, a statement of the insurance subsidies they received last year.

Others who remained uninsured last year may have to pay a tax penalty. This year, that penalty is $95 per person ($47.50 for each child) or 1% of household income, whichever is greater. The most a family will pay this first year is $285. Fines will go up next year. Some consumers may be able to avoid the fine by applying for an exemption.

An unfortunate pitfall may await those who remain uninsured and put off filing their taxes this year. The deadline to enroll in 2015 health coverage through the Health Insurance Marketplace is February 15th, two months before the April 15th tax filing deadline. Uninsured individuals who wait until after February 15th to file will have to pay this year’s penalty and will have missed the deadline to apply for 2015 coverage and tax credits. This may lead to a higher penalty on next year’s taxes.

Help people avoid the penalty for 2015
Encourage consumers to review their 2015 coverage options to get insurance!

Enrollment Answers and Help
Covering Kids & Families, leading the Southern Wisconsin Navigator Collaborative, has licensed Navigators available to help people in southern Wisconsin enroll. Contact any office to get answers to questions or learn about in-person enrollment help.

Madison: Covering Kids & Families – 608-261-1455
Milwaukee: Covering Kids & Families – 414-270-4677 and Gerald Ignace Tribal Health Center (Milwaukee) – 414-383-9526
Platteville: Southwest Community Action Program – 608-348-9766
Racine & Kenosha: Racine Kenosha Community Action Agency – 262-637-8377
Janesville: First Choice Women’s Health Center – 262-902-8572
Dial 2-1-1 anywhere in Wisconsin to find in-person enrollment help in your area.

Tax Help
For more information on taxes and health insurance, check out H&R Block’s ACA Tax Impact page. Individuals with low incomes can get free tax filing assistance at Volunteer Income Tax Assistance (VITA) sites, and people over age 60 with low-incomes can get free assistance at AARP TCE Tax-Aide sites. Check if you are eligible for assistance, then find a free tax assistance site near you.

VITA sites: Call 1-800-906-9887 or visit the IRS Website
AARP TCE sites: Visit AARP’s site finder Website
Dial 2-1-1 for information on all sites in your area.