Many of the couples I am working with in my divorce mediation practice elect to remain married so they can keep the health insurance coverage they have with their spouse. The Patient Protection and Affordable Care Act (ACA) may provide them with an affordable health insurance option that will allow them to obtain an immediate divorce.
Beginning October 1, 2013, the ACA allows individuals and small businesses (those with less than 50 employees) to use an exchange to see if they are eligible to obtain health insurance coverage. If they are eligible, individuals and small businesses can enroll through a website, over the phone, in person or by mail.
Each state was able to decide if it wanted to create its own exchange or use the one established by the federal government. New York elected to establish its own exchange and residents can find information either at www.nystateofhealth.ny.gov or by calling 1-855-355-5777 toll-free.
According to official estimates, over one million New Yorkers will buy their health insurance on the state’s exchange by the time it is fully implemented, including approximately 615,000 individuals and 450,000 employees of small businesses.
The New York site reports that approved health insurance rates for 2014 will be 53% less than what is currently on the market because more people, especially the young, will be entering the insurance pool. This is also the reason why you will not be denied coverage even if you have a pre-existing condition.
The plans from the 16 insurance companies that will be selling on New York’s marketplace will vary in cost, and have different doctors and providers in their networks. However, each must cover the same core set of ten benefits, including maternity care, prescription drug coverage and hospital stays. For information on the 4 types of plans, see my article Coming to a Computer Near You.
Coverage will become effective on January 1, 2014 and you will have until March 31, 2014 to enroll. After this year, open enrollment will be between October 15th and December 7th. However, you must enroll by December 15, 2013 to have coverage in place by January 1st, 2014.
Individuals with Healthy New York, Child Health Plus or COBRA can replace their plan with one found on the marketplace as long as they do it during open enrollment. In my next two articles, I will outline in more detail how the ACA impacts individuals, businesses with fewer than 50 employees and those receiving coverage under COBRA.
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