To sign up for a health plan under the Affordable Care Act you can go directly to the online health insurance marketplace for Louisiana -- or you can get help in person or over the phone.
Where's the Louisiana Health Care Exchange?
You can find the health insurance exchange for Louisiana at HealthCare.gov. This is where you can learn about the various health insurance options available to you under the Affordable Care Act. If you see a plan you like, you'll be guided through the enrollment process online.
This article explains the costs of health care plans offered under the Affordable Care Act (commonly called Obamacare) for individuals or families who are currently uninsured or not covered by a job-based health plan.
What you'll pay for an Obamacare plan depends on five things:
The level of coverage you choose
Whether you qualify for a subsidy
Where you live in Louisiana
Whether you smoke
Read on to learn more about each of these factors.
Despite what you may have heard, you can’t be arrested or thrown in jail if you don’t have health insurance in Louisiana. You may, however, be forced to pay a tax penalty if you aren't enrolled in a health insurance plan that meets the requirements of the Affordable Care Act.
To avoid the penalty, you must either obtain qualified health coverage or prove your eligibility for an exemption.
What Qualifies as Coverage?
If you have any of the following types of health coverage, you won’t have to pay a penalty:
an individual insurance plan, whether purchased on your own or through HealthCare.gov, the exchange serving Louisiana
a plan (including COBRA or a retiree plan) provided by your employer
Medicare, Medicaid, or coverage under the Children’s Health Insurance Program (CHIP)
TRICARE (coverage from the U.S. military)
coverage under a veterans health care program more...
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As Obamacare enters its open enrollment period for 2018 health plans, those seeking coverage face more chaos than ever. For many Americans, affordable coverage and streamlined enrollment still seem like faraway goals.
Below are a couple of strategies to help you get your health insurance needs met.
Common Complaints from Health Insurance Applicants
The list of complaints from those caught in the health exchange bureaucracy is long, commonly including:
the U.S. government doesn't really care about affordable health care for its citizens
Do you have to worry about IRS Forms 1095, 8965, or 8962? The Affordable Care Act, aka Obamacare, requires you to do one of the following three things when you file their taxes this year:
confirm they had health insurance coverage for 2016
claim an exemption from health coverage, or
pay a penalty when they file their return.
This remains true even though the Trump administration has issued an executive order allowing the IRS to accept tax without health insurance disclosures. Under the Affordable Care Act, you are still required to pay any Obamacare tax penalty you owe, and the IRS may question you if you fail to report your health insurance status on your tax return. The new rule does, however, imply that the Trump administration may not aggressively pursue people who don't pay their penalties.
Here’s what you should know about filing your taxes in this confusing era of health insurance reform.
Get a colonoscopy, mammogram, vaccinations, and other essential services for free
The Affordable Care Act requires health insurance plans to offer certain preventive care services free of charge -- or more accurately, for nothing more than the cost of your monthly insurance premiums. This rule applies to most plans sold directly by insurance companies and all plans sold through HealthCare.gov, the health care marketplace for Louisiana. Covered preventive services are available for free (meaning no co-pay or other out-of-pocket charges) whether or not you’ve met your plan’s annual deductible.
Tips for Using Your Preventive Care Benefits – And Avoiding Unexpected Charges
Below, you’ll find a list of free preventive benefits -- screening tests, counseling services, and vaccinations -- for adults, women, and kids. But first, here are some pointers to help you avoid an unexpected bill for services you thought were preventive.
Use a network provider. To get a preventive service for free, you must use a health care provider in your insurance plan’s network.
One way to satisfy Obamacare’s health insurance requirement is to obtain coverage under Medicaid. If you qualify for Medicaid and enroll in Louisiana's Medicaid program, you do not have to sign up for another insurance plan.
It’s Going to Get Easier to Qualify for Medicaid in Louisiana
The Affordable Care Act expanded Medicaid eligibility to cover more people who can’t afford health insurance. The U.S. Supreme Court later decided that it was up to individual states to decide whether or not to expand Medicaid.
On January 12, 2016, the governor of Louisiana has announced a decision to expand the state's Medicaid program, beginning July 1, 2016. If the Medicaid expansion plan goes through, you will qualify for Medicaid if you earn up to 138% of the federal poverty level. (For 2017, 138% of poverty level is about $16,643 for an individual or $33,948 for a family of four.) Medicaid expansion is expected to extend coverage to about 300,000 currently uninsured state residents.
Many self-employed people will be quick to tell you that getting and paying for health insurance is one of the biggest hassles they face. But this may change for the better under Obamacare, which provides new coverage options for the self-employed.
Are You Self-Employed or an Employer?
Before you start evaluating your options for health coverage, you need understand whether you are in fact considered self-employed under Obamacare.
The law says you are self-employed if you are an independent contractor or a sole proprietor without employees. (If you hire other independent contractors to do some work for you, you probably still qualify as self-employed.) Self-employed people can use the new health care marketplace to purchase individual health insurance plans.
If you have employees – usually, workers whose income you report on a W-2 at the end of the year -- you’re considered an employer. In that case, you can learn about purchasing health insurance for yourself and your employees through the SHOP Marketplace.
What Obamacare Means for Self-Employed People in Louisiana
Here are six things self-employed people should know about the Obamacare health insurance reforms:
You must have health insurance, unless you are legally exempt. If you don't, you may have to pay a tax penalty. There are limited exceptions to this rule.
You can't be denied coverage or charged more because of pre-existing health conditions. If you've been turned down or priced out in the past, you should have new options for coverage under Obamacare. more...
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The difficulties of unemployment are often compounded by the lack or loss of health insurance. But millions of Americans who are currently without both a job and health coverage may find relief under Obamacare. That's because new coverage options are now available through HealthCare.gov, the health insurance marketplace serving Louisiana.
All plans available through the marketplace offer essential medical benefits, including preventive care, emergency services, and prescription drug coverage. You can't be turned away if you have a pre-existing medical condition and, as an unemployed person, you probably qualify for significant cost-saving subsidies.
When you sign up for a marketplace health plan, your coverage can start within a few weeks. Usually, you must sign up during an open enrollment period. But leaving your job and losing job-based health insurance makes you eligible for a special enrollment period. That means you'll have 60 days to sign up for a new health plan.
When registered domestic partners or civil union partners apply for coverage in the new health insurance marketplace, there’s one question that almost always arises: Do we apply based on our separate incomes, or must we include all the income we make as a couple?
The answer depends on the state where you live.
States other than California, Nevada, or Washington. In almost all states, registered domestic partners or civil union partners who apply for insurance via the state’s health insurance exchange must do so separately. Each partner includes only his or her separate income, and this amount determines health plan costs and eligibility for cost-saving subsidies. It works this way because domestic partners are not considered married for federal tax purposes. (If you registered first and got legally married later, this article doesn't apply to you. You must apply as a married person and report your combined income.)
California, Nevada, or Washington. In these states, which extend community property laws to registered domestic partners, domestic partners must usually apply using half of the partners’ combined incomes. (We confirmed this with the legal department at Covered California after repeatedly receiving conflicting information from representatives staffing the exchange’s customer service phone line.) This is because IRS rules require that domestic partners registered in these community property states report half of their combined community income on their federal taxes each year.
If you’re over the age of 65, your health insurance options under the Affordable Care Act depend on whether or not you’re covered by Medicare or another insurance plan. To find out what, if anything, you need to do, find the situation below that applies to you.
You have Medicare. If you’re already enrolled in Medicare, you’re considered covered under the ACA, and you don’t have to do anything. In fact, it’s illegal for someone who knows you have Medicare to try to sell you a plan through a health care marketplace.
The Affordable Care Act enhances your existing Medicare coverage in a couple of important ways:
When Obamacare launched, the federal and state health insurance marketplaces (also called “exchanges”) were plagued by technical troubles. Many people who tried to sign up for new health insurance plans online in the early days were unable to complete their applications.
Because of these difficulties, some individuals and application assistants turned to the old-fashioned way of getting health insurance -- paper applications.
Applying on Paper May Not Be Better or Faster
When facing a slow or broken online health insurance exchange, using a paper application may seem tempting -- at least it would provide the feeling of getting something done. However, paper forms may not speed up the process at all. On the contrary, they could slow down your application even more.
The worker who reviews your paper application must manually enter the information from your forms into the same system you would use online at your state’s exchange. It won’t work any faster for them than it does for you. Plus, using a paper application opens up more opportunity for error by putting more people between you and your goal of getting insurance.
It’s still best to apply online if you can. That said, if you feel that you’re unlikely to come back and apply for health insurance later, you may want to go ahead and complete a paper application now. Follow these steps to apply on paper.
All health plans purchased through the HealthCare.gov, the health insurance marketplace for Louisiana, must include the following benefits. These are known under Obamacare as “essential health benefits”:
Ambulatory patient services (meaning outpatient care you receive without being admitted to a hospital)
Hospitalization (including surgery)
Maternity and newborn care
Mental health and substance use disorder services (including counseling and psychotherapy)
Rehabilitative and habilitative services and devices (for people with injuries, disabilities, or chronic conditions, to strengthen their mental and physical skills)
If you used the marketplace to purchase a plan last year. Most people who purchased their 2016 insurance plan from an online marketplace will be able to automatically renew their coverage for 2017. While automatic renewal sounds convenient, it has serious downsides:
If your insurer decides to cancel your current plan, you could be switched to another plan without warning. The new plan may cost you more or change your eligibility for financial assistance.
Automatic re-enrollment could mean you aren't getting the right subsidy package. That could leave you facing higher monthly premiums now or -- if you take more assistance than you're eligible for -- a big tax bill later.
You may miss out on a better deal or better coverage if you don't compare all available plans to your current plan.
While allowing yourself to be automatically re-enrolled is better than going without insurance, it's best to take advantage of open enrollment and research your options. Shop around and evaluate new plans and costs. Even if you decide to stay with the plan you have, you can use open enrollment to confirm your personal information and ensure you're getting the right amount of financial aid.
If you purchased an individual or family insurance plan outside the online marketplace. As long as the plan meets Obamacare's coverage requirements, you can keep it. Or, you may use HealthCare.gov to compare plans and replace it. If you keep your current plan, you won't be eligible for the cost-saving subsidies available for plans purchased through the exchange.
Be sure to check with your current insurance provider before canceling a health insurance policy; you may have to wait until the end of your current policy year to make a change.
If you have insurance through an employer. As long as you're happy with your plan, you can keep it. You're considered covered under Obamacare. On the other hand, if you're not satisfied with the coverage you have, you may be able to switch to an individual plan through HealthCare.gov.
Keep in mind that if you buy a plan through the exchange:
Your employer will not have to pay a portion of your monthly premiums.
You may not qualify for cost-saving subsidies, even if your income falls within the eligible range. If your employer offers coverage that is considered affordable and sufficient under the law, you won't qualify to save on premiums or out-of-pocket costs for plans purchased through HealthCare.gov.
What is the health insurance marketplace?
The health insurance marketplace (sometimes called an "exchange") is where to go to get health insurance under the Affordable Care Act. The marketplace for Louisiana is HealthCare.gov. You can use the marketplace to compare plans, learn whether you qualify for cost-saving subsidies, and sign up for the plan that works best for you.
Where can I get in-person help with my application?
In Louisiana, if you need help understanding your options for coverage under Obamacare or signing up for a plan, you're can get assistance from a trained “navigator” or from a health insurance broker or agent.
Navigators can explain your options, answer your questions, and help you apply for the plan you choose -- but they can't recommend a specific plan for you.
Private insurance agents or brokers can also help you understand your health care coverage options under Obamacare. Unlike government-trained navigators and counselors, they are allowed to suggest the best plan for you.
Find a helper. To find help in your area, go to Find Local Help at HealthCare.gov. There, you enter your city and state or zip code to get a list of navigators, insurance agents, and brokers near you.
Talk to a licensed broker. To directly connect with a Louisiana insurance broker who can help you evaluate insurance plans and choose a plan that's appropriate for your situation, call 800-943-6832. (We receive advertising income from the licensed brokers who offer their services through this telephone number.)
"Open enrollment" is the period of time, once a year, when you can choose or change your insurance provider or what kind of plan options you want -- for example, monthly premium and annual deductible amounts -- for the upcoming calendar year. For the dates of the next open enrollment period, see What Louisiana Residents Need to Know About Obamacare.
Choose carefully, because after you make your choices, you must usually live with them until the next open enrollment period.
"Special enrollment" is an exception to the usual enrollment rules. If you qualify for special enrollment, you can sign up during a time period outside of the open enrollment period. The circumstances under which you may qualify for special enrollment include:
You should purchase a plan from the marketplace in the state you consider your primary residence -- where you vote, pay taxes, and so on. But snowbirds need to be sure they choose an appropriate “multistate” plan.
Some multistate plans may be restricted to a certain region – for example, a metropolitan area that straddles state boundaries. Others will be more appropriate for someone who migrates longer distances, spending, say, summers in Alaska and winters in Arizona.
Ask the insurance provider for details, and don’t sign up for a plan until you’re sure it will cover you where and when you need it.
What if I travel frequently?
Traveling shouldn't present any problem under a marketplace insurance plan. Simply sign up for a plan in the state of your primary residence. The plan will cover you in case of emergencies that happen out of state.
For more information about Obamacare in any state, including a link to the state’s health insurance exchange, choose the state from this list.
Information & Documents to Have on Hand
Here's a checklist of information to gather before you apply for health coverage at HealthCare.gov.
Social Security numbers for you and other members of your household who will be covered by your insurance plan
Policy numbers for any current health insurance plans
Documents to help you calculate your annual income. Include all sources, such as employment, pensions, alimony, rental property, or other income. If you have a job, gather together pay stubs or W-2 forms. If you’re self-employed, have last year’s tax return handy, as well other records that can help you estimate your yearly income.
If you or anyone in your household is eligible for job-based health insurance, a completed Employer Coverage Tool for each available plan
A good idea of your budget for health insurance, so you know how much you can afford to spend each month. This will help you choose the best plan from among those offered to you.
HealthCare.gov offers an Application Checklist you can print to help you keep track of everything you'll need to sign up.
Finally, keep a list of any questions you want answered before you sign up for a health insurance plan. To get answers to your questions, or for information on signing up for a plan, see How Do I Sign Up for Obamacare in Louisiana?
About This Website
Press Release: New Website Provides Local Obamacare Information
September 23, 2013
A new website, ObamacareByZipCode.com, gives people the answers they need about the Affordable Care Act (Obamacare). In plain English, it guides consumers to reliable, local information about their new health insurance options.
When users choose their state or enter their zip code, they will quickly find:
whether or not they’re required to get health insurance
what the available plans cover
how much coverage will cost, and
how to sign up in each state.
For consumers concerned about cost, the site shows how to determine whether they qualify for subsidies. It also explains the new rules about expanded Medicaid eligibility.
The new site was created by Albin Renauer, founder of LegalConsumer.com, and is coauthored by Renauer and legal editor and writer Shae Irving. LegalConsumer, which until now has concentrated on consumer bankruptcy, began in 2005, when Congress overhauled federal bankruptcy laws.
“When politicians tried to make it harder to file bankruptcy, I vowed to make it easier. When I read about politicians making it hard to get information about Obamacare, it got my blood boiling -- and I realized I could help folks find that information the same way I do with bankruptcy.”
Some states, says Renauer, are hiding the ball when it comes to the new options for healthcare coverage under Obamacare. Missouri, for example, has not created an insurance marketplace (exchange), forbids state officials from cooperating with the federal government, and provides no information. “It is being run like a covert operation, with no marketing or detailed information about its products or their prices,” wrote the New York Times. (Missouri Citizens Face Obstacles to Coverage, Aug. 2, 2013.)
On ObamacareByZipCode.com, all consumers need to do, says Renauer, is start with a zip code. The site will guide them to all the official local resources they need to make sure they get the maximum benefits under the law.
Another reason for expanding a bankruptcy website to cover health care reform? It’s obvious to Renauer: “Huge medical bills are a major reason that people are forced into bankruptcy.”
LegalConsumer.com has helped more than a million consumers navigate the bankruptcy process by providing a free online “means test calculator,” which shows people whether or not they’re eligible to file for bankruptcy.
After receiving his J.D. from the University of Michigan Law School in 1985, Albin Renauer worked for various public-interest law firms in the Bay Area and as a staff attorney for Chief Justice Rose Bird of the California Supreme Court. He spent 17 years as an editor at leading do-it-yourself legal publisher Nolo, where he helped create numerous books and software programs, including the bestselling Quicken WillMaker. He also edited Law on the Net, the first online directory of legal resources, and was the architect of Nolo's Webby Award winning website.