Many people have periods where their finances aren’t going well. One of the things that becomes worrisome is whether or not you can have some kind of health care coverage. That’s what we’re going to talk about today, but we’re going to focus on how it works in New York state, although every state in the nation has some kind of program that you can check out. These aren’t part of insurance coverage people get from their employers; if you have that kind of coverage, you won’t qualify for any of these tiers.
In essence, there are 5 tiers of health care coverage; they are:
1. Tiers of coverage, listed by elements; in essence, they’re levels of insurance coverage you will pay for with the name of metals; gold, silver and bronze. Some will cover the same exact things for the same price, but others allow you go pay the highest level for more coverage while others pay less for basic coverage, but at least you’re covered.
2. Essential benefits; this means that every level of insurance you apply for covers certain mandatory things such as emergency coverage, x-rays, doctor visits, etc. Some states mix dental coverage in with regular health care, while some don’t; even if it’s covered, you might have to search for a dental office that accepts your coverage.
3. Tax credits; this means that if you’re paying for insurance coverage while you’re employed, self employed or not, you might qualify for tax breaks when it’s time to do your yearly taxes. Once again, this is federal taxes only.
4. Open enrollment; some states have specific periods of open enrollment, which could mean a 3-month period where you can go through the process to see if you can obtain coverage. Sometimes they’ll have leeway for emergency coverage opportunities. Other states might allow you to apply for coverage any time throughout the year.
5. Health insurance exchanges; there’s two versions of this. One gives people more opportunities to look at more than one insurance company instead of only having one option. Some insurance cover certain procedures better than others, while allows you to shop for the best coverage of something that’s important to you.
The second is the one we’re going to talk about, because it’s possibly the most important to those in need. Once again, it’s more geared towards New York state residents, but most other states have something similar to what we have.
You actually have two different choices. The first, if you have money put away, or you’re living on your reserves, you can go to the NY State of Health website. If you want to learn more about it, go to the frequently asked questions page. Every year from October through December, you can go through the listing of all insurance companies that are part of the ACA plan to see which insurance you might want to purchase. Some are traditional names like Blue Cross, while others might be smaller insurance companies that offer plans for less money in certain areas. The site will tell you the date when you have to make your decision, and you’ll start paying that plan at the beginning of the year.
The second is if you’re in financial trouble. There’s no specific time when you have to wait to contact someone. The first step is to contact your local health department, which is run by certain counties and New York City. Some of the smaller counties might transfer you to a different county to talk to someone, but you’ll eventually get to talk to someone.
When you finally get to talk to someone, tell them what your situation is. If you can’t continue paying on the plan you selected at the beginning of the year, or you don’t have insurance, tell them that. Once you answer some of the initial questions they’re going to ask you, then it’s time for them to go through the process of determining whether you qualify for free insurance through the state or a much reduced amount based on your personal status.
The main questions concern:
* how many people need to be covered
* how much money you’ve made during the year
* if you’re working a low paying or part time job, what’s your weekly or monthly payment amount
Depending on how these questions are answered, there might be more. The process can take up to an hour to go through, but if you qualify for assistance it will relieve your mind of worry.
If you’re in further financial distress, they might transfer you to talk to someone else, who’d either ask you to go to the country offices or have you fill our an online form that might qualify you for food assistance, assistance in finding a new job with the county and a host of other positions, or give you relief towards your utilities. There’s other things you might qualify for to help you put your mind at ease for a while, but you have to make the first step by picking up the phone and calling someone, or checking out the websites shared above.
As I said earlier, every state has something, but not all states offer the same things New York does. Remember, even if it feels like it is, you’re never alone. Good luck!
T L Wall Accounting Blog
