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I don't have health insurance

I don’t have health insurance.  Will I have to get it, and what happens if I don’t?
The Affordable Care Act requires most Americans to have insurance by 2014 or pay a penalty.  The penalty starts at $95 for one person, or up to 1 percent of income, whichever is greater.  The penalty rises over time to $695, or 2.5 percent of income, by 2016.  The penalty for families who don’t have insurance goes up to $2,085 or 2.5 percent of household income, whichever is greater.  Some people will not have to pay the penalty due to financial hardship or religious beliefs, for example. 

If you work for a small business in Travis, Hays, or Williamson County, your employer may be eligible to participate in TexHealth Central Texas,  a community-based nonprofit company offering a low-cost health benefits.   For more information, visit TexHealth’s website:  http://www.texhealthcentraltex.org/.

The Texas Department of Insurance also administers an insurance program for small employers called Healthy Texas.  To learn more about this program, visit http://www.tdi.state.tx.us/health/healthytexas.html.

 

Are there any tools that would help me find insurance in my area?
The Affordable Care Act requires the development of a website to help people find health coverage in their area.  That website is:  http://www.healthcare.gov/.  You answer questions about yourself and where you live and the website provides information on coverage that may be available to you.  The website does not contain any pricing information, which is planned to be added in October 2010. 

For additional information about Texas insurance options, please visit www.TexasHealthOptions.com.  Some companies licensed to write health insurance in Texas may not be listed on www.healthcare.gov.  To verify if a company is licensed in Texas, check the Texas Department of Insurance’s company lookup at https://apps.tdi.state.tx.us/pcci/pcci_search.jsp.

 

I want health insurance but I can’t afford it.  What do I do?
Depending on your income, you might be eligible for Medicaid, the state-federal program for the poor and disabled, which will be expanded sharply beginning in 2014. Low-income adults, including those without children, will be eligible, as long as their incomes didn't exceed 133 percent of the federal poverty level, or $14,404 for individuals and $29,326 for a family of four, according to current poverty guidelines.

Depending on your income, you might be eligible for Medicaid beginning in 2014.  Adults with incomes at or below 133% of the federal poverty level are likely eligible ($14,404 per year for individuals and $29,326 per year for a family of four today).

If you live in Travis County, you may be eligible for Central Health’s Medical Assistance Program (MAP).  Your income must be at or below $10,830 per year for an individual and $22,050 per year for a family of four to qualify.  Elderly and disabled individuals can have a slightly higher income and still qualify.  For more information on MAP, visit http://www.centralhealth.net/healthcare_services.html


If you work for a small business in Travis, Hays, or Williamson County, your employer may be eligible to participate in TexHealth Central Texas,  a community-based nonprofit company offering a low-cost health benefits.   For more information, visit TexHealth’s website:  http://www.texhealthcentraltex.org/.

The Texas Department of Insurance also administers an insurance program for small employers called Healthy Texas.  To learn more about this program, visit http://www.tdi.state.tx.us/health/healthytexas.html.

 

I have a pre-existing condition.  Can I get insurance under health reform?
The Affordable Care Act creates a temporary high-risk insurance pool for people with medical problems who have been rejected by insurers and have been uninsured for at least six months.  That high-risk pool, known as the Pre-existing condition Insurance Plan, is being run by the federal government for Texas, which opted not to run the plan, and applications are currently being accepted, with coverage beginning on August 1, 2010.  To apply, go to http://www.pcip.gov/.  You must be a U.S. citizen or legal resident with a pre-existing condition without health coverage for the previous six months.  The estimated premium for a 50 year old will be between $491.00 and $600.00 in Texas.  Yearly out-of-pocket costs are limited to $5,950 for individuals and $11,900 for families, excluding premiums. 

The State of Texas also has a high-risk health insurance pool, which has different requirements from the federally-run high-risk pool under the Affordable Care Act.  To learn more about the state pool, visit http://www.txhealthpool.org/index.html.