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The Affordable Care Act: What to do if you're uninsured

Local 5 breaks down what you need to know
GREEN BAY, Wis. (WFRV)--Nearly 500,000 people in Wisconsin are uninsured, according to recent data—but under the Affordable Care Act that group will soon be required to sign up for insurance or face penalties.   

“October 1st the Federal Exchange opens and people can then look at the exchange,” the Wisconsin Commissioner of Insurance Ted Nickel tells Local 5 News.

So what do you do if you’re uninsured?

There are 3 very important dates to remember:  October 1st you can log onto healthcare.gov and begin looking at plans.

By December 15th, your fist premium payment is due and on January 1st 2014, your coverage begins.

Those who ignore these deadlines will be forced to pay a fine of $95 or 1-percent of their income, whichever is greater.

“If you should fail to do that, you’re out.  You cannot get sick and then get insurance if you will.  You’re out until the next enrollment period begins next October,” said Nickel.

Unlike other states who accepted federal funding for Health Insurance, Wisconsin did not, which means the state will be providing coverage for all children under the age of 19 and for families and individuals who qualify.

“If somebody is low income, under the 100% of poverty, there is no fee for Badger Care Plus for those low- income [people]. There are no premiums for that population so
there’s not a cost,” said Jenny Hoffman, the Economic Support Administrator with the Brown County Human Services Department.

About 92,000 people who are currently on Badger Care will be dropped, which is a real concern for those who work in health care.

“Our real concern is now that the poverty level for Badger Care has dropped 100%, there are going to be a number of families that fall through the gaps and won’t remain in coverage unless they go out to the market place,” said Trish Sarvela, the Development Director for the Partnership Community Health Center.

Those people along with the uninsured group will have to sign up through the Market Place.

There are 13 companies in Wisconsin, according to the Insurance Commissioner’s Office, that will be providing individual insurance plans. 

Some are only offered in certain regions and counties so it’s important to check, but with more options comes a price.

“It’s homogenizing what’s available to consumers. So consumers on the individual side are going to see increases in the amount of premiums they pay,” said Nickel.

While this may be an added expense for many, not having insurance will cost you more if any medical issues occur.

“After January 1st when they go to pick up that prescription, they’ll have to be paying out of pocket,” said Sarvela.

So what if you lose your job after January 1st and need to purchase insurance? 

Nickel suggest: “You would then be able to purchase health insurance individually through the Exchange or in the outside market based on your circumstances.”

For those people—they’ll be covered through the next open enrollment period.  Same applies to anyone who moves out of state or gets married. 

Everyone else will be required to pay their first premium by December 15th. 

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