Buying Insurance Via Obamacare? Beware the Narrow Network

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Still don’t have health insurance? Time is running out. The deadline to sign up for health insurance is just days away.

If you’re still searching for coverage, take heed of the following:

Limited network

Many health insurance plans sold on the Obamacare exchanges swap lower premiums for a narrow provider network. Be aware of this when you’re signing up for coverage, because going out-of-network could come at a cost, Kaiser Health News says.

These may include: separate out-of-pocket maximum costs for out-of-network services, potential charges for preventive care services that are free under your network plan, and higher co-payments.

Deadline and penalties

You have until March 31 to enroll and pay for a plan or face a potential penalty of $95 or 1 percent of your income, whichever is higher. The penalty will be assessed on next year’s tax return. The penalty for uninsured children, under age 18, is $47.50, with a maximum penalty of $285 per family.

The only way you can sign up for individual health insurance after March 31 is if you have a qualifying life event, like moving out of state, changing jobs or having a baby.

Off-exchange plans

Only those who use the online government marketplaces to buy insurance are eligible for a subsidy, in the form of a tax credit, to help them afford the premiums. But if you make too much money to qualify for a subsidy, you might want to consider purchasing a health insurance plan from a certified insurance website or use a certified insurance broker to help find a custom plan for you.

This leaves you with greater flexibility in choosing your health insurance and the possibility of a broader provider network. But you still need to enroll by March 31.

Changes are slated for Obamacare in 2015. The Obama administration is ordering the insurance marketplaces to “include a more robust offering of care providers in 2015,” The Washington Post said. Health plans offered on the government marketplaces next year will be required to include 30 percent of area “essential community providers,” like health centers and hospitals that serve mainly low-income patients. The 2014 requirement was 20 percent.

Are you covered by Obamacare? We’d love to hear from you. Please share your experiences below or on our Facebook page.

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Comments & discussion

We welcome your opinions, but let’s keep it civil. Like many businesses, we reserve the right to refuse service to anyone. In our case, that means those who communicate by name-calling, racism, using words designed to hurt others or generally acting like an uninformed bully. Also, comments that include links to email addresses or commercial websites typically aren't posted. This isn't a place to advertise your business.

  • I.Popoff

    How are they going to determine who has insurance and who doesn’t so they can assess the penalty? Is there a massive data base of information about everyone or are they going to ask you to submit this information on your income tax form?

  • drhoffman

    The individual mandate is not longer “mandated” if you can prove any type of hardship (time limit, lack of funds, etc.) As for how the IRS will know if you have insurance? No different than when you receive a 1099 for investments that are reported to the IRS. I would gather that the insurance companies will report social security numbers to the IRS and via computer, they can match tax filers to reported insurance coverage.