There are only five days left for individuals to enroll in new health insurance coverage under the Affordable Care Act, if they want that coverage to begin Jan. 1. But central New York insurers are urging people to avoid waiting until the last minute.
Dec. 23 is the last day individuals can sign onto a health insurance policy through the exchange and guarantee health care coverage on New Year’s Day. But it’s not just getting through the application process that’s important. Todd Muscatello, vice president of Syracuse's Excellus Blue Cross Blue Shield office, says individuals also need to pay their health care insurance premium by Dec. 31.
"If a member sends in their application, but doesn’t send in the payment until Jan. 5 -- to use an example -- but on Jan. 3 that person goes to see a provider, the insurance company is not going to know," Muscatello said. "They’re not going to have them in the system. So that person could be asked to pay out of pocket, and have to be reimbursed by the health insurance company, after they submit the payment.”
Muscatello says one thing that’s confusing about the process is that there is another March deadline out there.
“The enrollment period still allows for people to enroll and not have to worry about the penalty through the end of March," Muscatello said. "You just won’t have coverage effective January 1. So if you decide to enroll after Dec. 23, into January, you can still get coverage. It just won’t start until Feb. 1.”
Muscatello also says there have been new deadlines about late payments recommended by the federal government. But he notes that New York state hasn’t indicated whether those grace periods should be mandated, so insurance companies are in a bit of limbo on that front, waiting for word from Albany.
“In the last four or five days, there’s been a lot of things released at the federal level that New York state hasn’t commented on yet," Muscatello said. "So things like grace periods and all that type of stuff, we’re still waiting to see what New York state is going to do, because a lot of those things the federal government didn’t mandate it said it strongly recommends.”
He says the best way to ensure coverage is to meet the December deadlines. Along with the New York state of Health website, individuals can get help deciding on a policy from community organizations, insurance company websites and private insurance brokers. Muscatello notes the only way to access the tax breaks connected to income is to sign up through the state website.
Overall, he says while the process has had its fits and starts, the New York state exchange is working well for the most part.