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“Open Enrollment” for 2015, which is the time when you can sign up for health insurance and, if you qualify, get subsidy for the premiums, ends on February 15. With that deadline fast approaching you may want to consider the reasons you should consider getting coverage.

  1. You won’t have an opportunity to enroll after February 15. Many people believe that they can enroll once they may have a need for insurance, and while that may sometimes be the case, there is almost always a delay during which you remain uncovered and responsible for all costs incurred.
  2. You can protect yourself from financial devastation. Like car insurance, health insurance covers costs most of us could not possibly afford, and gambling on continued good health can result in huge financial losses. An unexpected illness or accident can lead to hundreds of thousands if dollars in expenses. This is one of the most common reasons that people have to file for bankruptcy.
  3. You can gain access to primary care and preventive care. Under the Affordable Care Act annual physical exams and important preventive care, such as age appropriate cancer screenings, are free, even if you have not yet met your deductible. And as primary care transforms to a more comprehensive approach, which often includes mental health services, oral health and care management, you can gain access to these important resources. This also assures access to appropriate follow up care if you do have an unexpected healthcare need.
  4. You may qualify for a subsidy! People who are not offered affordable health insurance through their employer qualify for subsidy if they earn between 100% and 250% of federal poverty level (FPL). For example, for a family of 4 this is an income range of $23,850 to $59,625. So if you are a family of 3 with one child and two adults, each 30 years old and neither of whom smokes, with a household income of $35,000, you could get a silver plan (very good coverage) for $154 per month (normal cost would be $776 per month). The FPL numbers can be found here: http://obamacarefacts.com/federal-poverty-level/ and this is a very helpful premium calculator from the Kaiser Family Foundation: http://kff.org/interactive/subsidy-calculator/
  5. There are options. If you are young and healthy and don’t qualify for subsidy, you may choose a catastrophic plan, to protect against devastating unexpected costs. There are also bronze plans, with higher deductibles in exchange for lower premiums.
  6. There is help! At PCHC we have Outreach and Enrollment specialists, whose sole job is to help you work through your options and choose the coverage that is right for you. You don’t have to be a PCHC patient – you can call 404-8080 to get more information. Additional help can be found at www.enroll207.com and at www.healthcare.gov .

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Noah Nesin, MD

Dr. Nesin, Vice President of Medical Affairs for PCHC, is a family doctor with 30 years of experience.

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