How the insurance exchange works

THE MARKETPLACE

Starting in 2014, most Americans will be required to have health insurance coverage or pay a tax penalty. Starting on Tuesday, uninsured Iowans can shop for and buy coverage online at the Health Insurance Marketplace. Individuals can choose from a series of providers and policy levels. Those who sign up will be automatically screened for eligibility to receive premium payment assistance and for eligibility in other health programs, such as Medicaid. Coverage can take effect as early as Jan. 1.

FIRST STOP

The website www.healthcare.gov is home to the health insurance marketplace and connects consumers to information and assistance. People can also call 1-800-318-2596 (TTY: 1-855-889-4325) 24 hours a day with questions. Health care providers can also provide information.

navigators

In much of the Corridor, Planned Parenthood of the Heartland has been designated as a “navigator” that will provide help and resources to consumers considering marketplace coverage. “Our strategy is to work with collaborative partners to identify the best avenues to reach individuals in their community. This will include partnerships with local organizations and staff to distribute information; hosting events and enrollment sessions; assisting in enrollment; and setting up personal appointments to review information and help Iowans enroll in the plan they choose,” said Shelby Cloke, spokeswoman for Planned Parenthood. Call (877) 811-7526

PREMIUM HELP

Iowans who sign up for insurance through the marketplace may be eligible for federal tax credits to offset the cost of insurance premiums. Credits are available to Iowans earning an adjusted gross income below 400 percent of the federal poverty line. That's $44,680 for a single person or $92,200 for a family of four.

IOWA HEALTH AND WELLNESS PLAN

Under the plan, Iowans with incomes below 100 percent of poverty who aren't otherwise eligible for Medicaid can get the same health coverage that insures state employees. Between 100 percent and 133 percent of poverty, individuals would get help buying marketplace coverage, with incentives for completing health and wellness goals.

penalties

Those who do not have insurance will face a tax penalty. According to healthcare.gov: The fee in 2014 is 1 percent of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5 percent of income or $695 per person, whichever is higher. In 2014, the fee for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285.

essential health benefits

All insurance plans, under the law, must include “essential health benefits.” According to healthcare.gov, the benefits include 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

FRAUD WARNING

The Iowa Attorney General's Office says Iowans should be on the lookout for potential scams. The government will not contact you, either by phone or email, to solicit insurance enrollment. Be suspect of any contact from anyone claiming to be from the government seeking personal enrollment information.

I HAVE INSURANCE

If you have major medical insurance, or are already enrolled in Medicare, Medicaid or Hawk-i children's' health coverage, you don't have to change anything.