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Thursday, Dec 18, 2014
Healthcare Exchange Q&A

Will I get in trouble for going uninsured as I wait for Medicare?

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Q: As of Sept 2, I will no longer be receiving my severance COBRA health insurance for $345 a month. It will be going up to $1,062 a month, and I cannot afford this. I am on total disability and cannot receive Medicare until March 2014. For six months, I will be without insurance. My question is, will I be required to buy insurance in January even if I will be receiving Medicare in March? – Robert from Plant City

A: Timing is everything, right? You face some difficult questions in the coming months, compounded by the requirement that all Americans have some form of medical insurance by Jan. 1.

Your situation is very detailed and I can’t say for certain what exactly will happen, but here are some issues about the Affordable Care Act requirements and options you might want to consider:

Mandatory Coverage: The Healthcare Marketplace that opens for business on Oct. 1 is helping consumers shop for 2014 insurance plans. You’re right that the law says Americans need this coverage starting Jan. 1. But officials indirectly acknowledge it will be impossible to get everybody signed up, so in the first year, they are letting individuals sign up through March 31. That window might help you. Another rule allows people between jobs or health plans to be insurance-free for up to three months and still avoid any penalty.

Exceptions: There are ways people will be exempt from having to get health insurance. According to Healthcare.gov, the government’s official site for the marketplace, the reasons to avoid paying a penalty include: having an income so low that coverage is considered unaffordable; earning too little to pay annual federal taxes; participating in a health care sharing ministry; or participating in a religious group with objections to health insurance.

Also, you are exempt if you would qualify under Medicaid’s expanded income limits but live in a state that hasn’t expanded the program for the poor and disabled. Florida is one of those states.

Medicare: Medicare, the government-backed insurance for seniors, may have additional rules that apply to your situation. Sign up starts months before a person becomes eligible at age 65, so it may be worth talking with experts there about your situation.

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