If you are still without health insurance, or wish to change your current plan, you still have a little time to select and apply for new Affordable Care Act (ACA)-compliant health insurance. You must apply by March 15, and March 31 is the close of this initial Open Enrollment Period, for an April 1, 2014 effective date.

After March 31, 2014, ACA prohibits purchase of new or replacement individual health insurance for the balance of 2014. The next Open Enrollment Period will run from October 15, 2014 to December 7, 2014, for a January 1, 2015 effective date.

These designated Open Enrollment Periods are designed to prevent individuals from postponing enrollment in individual health insurance until they need it (due to a serious injury or major illness). Remember, insurance of any kind is intended to be something you buy before you need it, not after the problem or loss occurs.

There are many benefits to the new ACA, which are worth repeating. Most importantly, all individual health insurance is available on a “guaranteed issue basis.” This means there are no health questions, no listing of your medications, no medical underwriting, no pre-existing condition exclusions. And the ACA has put a new $6,350 cap (or less) on your total shared cost of deductibles, co-pays, etc., which for the first time also includes all of your prescription costs.

So if you have major medical expenses, or take very expensive prescription medications, once you have spent $6,350 from any and all of your medical and prescription bills, your plan will pay 100% of all of your medical and Rx bills for the balance of the calendar year. Note: this does not apply if you use non-PPO Network Providers or if any medical services you receive are not “covered expenses” under your health plan (such as cosmetic surgery not resulting from an injury).

In addition, if your income is below 400% of Federal Poverty Level (about $43,000 for a single tax filer, and $63,000 for joint tax filers), you may qualify for a significant Premium Tax Credit to help pay your monthly health insurance premiums. To apply for health insurance with a Premium Tax Credit, you can only apply for your new health insurance through the new Covered California Marketplace (“The Exchange”). You can do this directly at www.coveredca.com or through a Covered CA Certified & Licensed Health Insurance Agent.

In addition, for those with incomes below 250% of Federal Poverty Level, you may also qualify for a Cost Sharing Subsidy (CSR). This will significantly lower your health plan’s deductibles, co-pays and annual out-of-pocket maximum. Again, CSR is only available when applying through the new Covered California Marketplace. This CSR, along with a Premium Tax Credit, can provide very rich benefits at a very low net cost to qualified applicants.

Bill Robinson has been a licensed agent for 31 years, and is owner of Palm Canyon Insurance Agency in Palm Springs. (760) 416.4225