Topic ID #31415 - posted 2/24/2014 10:42 PM

CRM Field Technicians and the Affordable Care Act



erkay

My name is Evan Kay, and in addition to being a Field Technician in New Mexico, I'm also a Certified Health Care Guide for the state of New Mexico. I wanted to post about the Affordable Care Act, its mandate for individuals to carry health insurance or face tax penalties, and the remifications for CRM Field Technicians. Full disclosure: as a Health Care Guide in New Mexico, I focus on assisting New Mexico residents on enrolling with the New Mexico Insurance Exchange; I do not get paid by, nor work for, any particular insurance company. I can only directly help NM residents, but I want to share this information because I think it's important, and lot of it applies to residents from other states.

One of the hallmarks of being a Field Technician in CRM archaeology is that we are considered temporary employees, and often we have to follow the work where ever it is offered; in addition, work is almost never offered year-round. I have no stats on hand for CRM, but in NM work seems to be readily available only about 8 months out of the year. This position also rarely, if ever, comes with benefits such as health insurance. 

Having tried to purchase on the individual market before, I know that it's expensive, both in monthly premiums and out-of-pocket expenses such as deductibles. The plans I found would have required me to come up with $12,000 of my own money before they would kick in and cover anything. My premiums were high, and it didn't help that I bought the insurance right at a time when I changed age groups, kicking them up even higher. They could also drop me at any time if I became too sick to be profitable, and other family members were denied outright due to health issues. No matter what is said about it, the Affordable Care Act (ACA, Obamacare) has gone a long way towards making health insurance within reach of anyone who wants it. Plans available on the Marketplace the ACA created are required to cover a minimum standard of care, cover Emergency Services, insurers can't deny you coverage for a pre-existing condition, can't drop you because you get sick, and must have a cap on how much you will pay out of pocket during your lifetime. Depending on your income, you may be eligible for expanded Medicaid, and even enough financial assistance to bring the monthly cost of health insurance down to nothing!

If your income is truly low, many states (New Mexico is one) have taken the federal government's incentives to expand Medicaid. Eligibility is determined by household size, household income, ages and other criteria.

As an example, Sarah is 27, has graduated college, and lives alone with no kids and no disabilities; she works as a CRM Field technician, and has no health insurance through her job. Sarah is eligible for medicaid if her monthly income is less than $1,321. If Sarah's monthly income fluctuates (which it can, as she gets no vacation time or sick leave), multiply by 12 to get a yearly income. Sarah will qualify for medicaid if her yearly household income is less than: $1321X12 = $15,852. 

But what if Sarah makes more than that? If Sarah makes more than $15,852, but less than $45,960, then she is eligible for financial assistance if she buys insurance from the Marketplace. This comes in the form of tax credits, that she can apply right away to the cost of the insurance premium. Depending on how much she makes, her premiums can be reduced to nothing. She may even qualify for help with the out-of-pocket costs of health care, such as deductibles and co-insurance. And it is in her best interest to get insured. One of the criticisms of the ACA is true. This enhanced coverage came with a price: the individual mandate.

All individuals are now required to carry health insurance or face tax penalties. This year, 2014, the penalty is $95 or 1% of your income, whichever is the higher (sounds modest, but do the math: if you make just $16000, you do not qualify for medicaid, and the tax penalty is $160 if you don't buy insurance; at this income, you may also qualify for low or no cost health insurance). This will go up in 2015. The penalty can be avoided easily: get some insurance. There are many ways to go about this, but they vary state-by-state, and the state in which you maintain a residence is where you need to look for your options. Insurance can come from: 

  • your parents -- many CRM field techs are still students, and under the ACA, you can be covered by your parents' policies until you turn 26; 
  • your job -- if your job offers it;  
  • Veteran's Benefits -- if you are eligible to be seen at the VA, you're covered;
  • the private market -- the ACA didn't do away with policies offered by insurance companies, but they are not covered by the guarantees of care and coverage that Marketplace policies are (i.e. buy at your own risk; you can be denied, dropped and your premiums will increase with age);
  • your state's ACA insurance exchange -- either offered directly by the state or linked to the Federal Marketplace, and based on income, there may be financial assistance options; 
  • Expanded Medicaid -- one of the hallmarks of the ACA was allowing the expansion of Medicaid to individuals aged 19-64, based on low-income status, but one of the caveats is that although the Federal Government allocated funds to help offer this option, some state governments decided not to take advantage of it.

Creating an account on your state insurance exchange's website will allow you to figure out what option is best for you.  You have time. The deadline is March 31, 2014. If you don't have coverage by then, you may incur this year's penalty, but most importantly, you won't have insurance coverage and will have to wait until enrollment opens up again in October.  There are exceptions to this; being a member of a recognized Native American tribe or a recognized Alaskan Native gives you expanded protections and extra options for coverage; there are also exceptions for other reasons, but you need to be proactive to get those exceptions.

TL-DR; CRM field techs often don't have health insurance, because it's not offered by the employer for temporary positions. The ACA created affordable health insurance options, and if your income is low financial assistance may be available; the ACA also mandates that all individuals carry insurance or face tax penalties. Contact your state health insurance exchange or go to www.healthcare.gov before March 31, 2014, to find out what your coverage options are to avoid the penalty.

Questions? If you are a resident of New Mexico, keep reading. If you are not, go to www.healthcare.gov, and get your questions answered.

New Mexico Residents:

If anyone reading this is a resident of New Mexico and is unsure of how to proceed, I can help. I have the information on income levels in NM that indicate whether you qualify for Medicaid or financial assistance from the NM Health Insurance Exchange, and I am certified by the New Mexico Office of the Superintendent of Insurance to guide individuals through the process of getting insured. I work out of the Southwest Women's Law Center, the phone number is 505-244-0502. The folks there can point NM residents in the right direction and schedule appointments with various Health Care Guides. Again, I'm not paid by any insurance company, and don't recommend one plan over another; I can help guide NM residents through their options, if needed.

The NM Insurance Exchange website is http://www.bewellnm.com. It's open to any adult who lives in NM (even if your job offers insurance, you can shop there if you wish; the financial assistance incentive does not apply if your job offers insurance, except in limited circumstances). You can also go directly to www.healthcare.gov if you prefer.






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