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2 Things to Know Now About Enrollment

Question: What may happen to me or my family if we don’t meet the March 31st deadline to enroll in a health plan?

The deadline to enroll in a health plan is March 31, 2014. If you don’t enroll you face two big problems: one is that you may be charged a penalty when you file for your tax refund in 2015; the other is that you won’t be able to enroll in health coverage (except Medicaid if eligible) until November 15, 2014, with an effective date of January 1, 2015.

Unable to Buy Insurance:

Even if you don’t plan to enroll in a Marketplace plan, you will most likely not be able to enroll in any minimum essential health coverage in Ohio for the rest of this year, unless something happens in your life that entitles you to a special enrollment period (such as losing job based coverage).Receiving a serious medical diagnosis DOES NOT provide a special enrollment period.

Penalty:

You can compute the penalty you or your family will be charged by using this worksheet prepared by the Jackson Hewitt Tax Service. Please note that the reference to this worksheet does not constitute an endorsement of Jackson Hewitt or any tax preparing service.

You may also check this link to see if you qualify for an exemption to the penalty and what you must do to demonstrate that you meet the requirements of the exemption.

 

Question: I tried to sign up for the Marketplace on healthcare.gov. The computer told me I am eligible for Medicaid and I will hear something from the State of Ohio, but it’s March and I have not heard anything! What should I do? 

Answer: You have not heard from the State of Ohio because of problems with the electronic transfer of the federal files. The State of Ohio does not yet “know” that the federal Marketplace thinks you are Medicaid eligible. Here is what you can do.

  • File an application for Medicaid in one of these 3 ways: go to www.benefits.ohio.gov, call the Ohio Medicaid Consumer Hotline at 800-324-8680, or go to your local Job and Family Services office. You should receive a decision in 30 days.
  • If you have not received a determination in 30 days, (and you have provided all information requested, or asked Job and Family Services for help to get the information) you can file a request for a state hearing by calling or writing your local agency or writing to the Ohio Department of Job and Family Services, State Hearings, 30 East Broad Street, 31st Floor, Columbus, Ohio 43215-3414. You can also request a state hearing by sending an email to the Bureau of State Hearings at BSH@jfs.ohio.gov .You may also fax your hearing request to State Hearings at (614)728-9574. For more information on filing a hearing request go to http://jfs.ohio.gov/ols/bsh/faq.stm#2
  • If you believe that you are probably NOT Medicaid eligible (and about the only reason for that would be that your Medicaid household income is over 138% of the federal poverty level or because of your immigration status), file the Medicaid application anyway, in order to generate a denial. At the same time you should seek help from a Navigator, Certified Application Counselor or insurance broker to help you go back into your Marketplace application and work with the federal Affordable Care Act consumer hotline to make sure the Marketplace has the correct data that will demonstrate that you are not Medicaid eligible and that will then allow you to get a determination of your subsidy and help you with selecting a plan. For more information on finding help go to Find Local Help or call UHCAN Ohio at 614 456 0060 x 228.

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