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This year brings the highest penalty yet since the mandate was implemented in 2014. The penalty is $695 per adult and $347 per child up to a family cap of $2,500 or 2.5 percent of household income, whichever is greater.
President Donald Trump and Congressional Republicans have taken steps to repeal and replace the health care law, and Trump recently signed an executive order that would allow federal officials to defer or grant exemptions to the tax penalty.
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But the mandate is still in place, and it is expected to prompt a flood of last-minute enrollees on top of the 230,925 Ohioans, including 21,614 in Dayton, who had signed up for marketplace coverage as of Jan. 14, according to the U.S. Department of Health and Human Services.
Plans will run through the end of the year no matter what happens with potential reform measures in Washington, D.C., and downtown Dayton-based CareSource — one of the largest insurers in Ohio’s federally facilitated marketplace with more than 70,000 members in the state last year — is offering the following advice to consumers who might be caught up in the last-minute rush:
* Look past the monthly premium and consider how often you will need to see the doctor. If you will be frequently visiting the doctor or specialist, choose a plan with lower co-pays or coinsurance. It may cost you less during the year.
* Before choosing a plan, check to see if the medications you currently take are included in the plan. Some plans may not cover certain medications, and it’s important to know if you may need to switch medications based on your plan.
* Verify if you will receive an Advanced Premium Tax Credit (a government subsidy available to more than 80 percent of marketpalce consumers that lowers monthly premium payments) and the amount.
* Do not ignore the deductible. Some plans may require you to reach your deductible before they cover prescriptions. This can be expensive if you take a lot of medications. Other plans, like CareSource Marketplace plans, instead have copays for medications, which can lower your out-of-pocket costs.
“We encourage everyone to take the time to research their options and avoid the common mistakes,” said Steve Ringel, President, Ohio Market at CareSource.
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