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How to get health insurance before March 31, 2014

Starting in 2014, most Americans will have to have health insurance or face a tax penalty, thanks to the much-debated individual mandate provision of the Affordable Care Act. The deadline to have coverage is March 31, 2014.

But don't wait until the end of the year to explore your options -- the time to think about health insurance for next year is now.

Here are ways you and your family can get covered:

• Enroll in a health insurance plan at work

Your employer must have notified you by Oct. 1 whether its employee health benefits meet the federal government's minimum standards for coverage. Most employer-sponsored plans do. Open enrollment for work-based health insurance and other benefits is usually in the fall. Get details from your company's human resource department to learn how to sign up.

• Get coverage as a dependent through a spouse's or parent's employer

Employer-sponsored health plans aren't legally required to extend benefits to spouses, but most of them do.

Get health insurance before March deadlineIf you're under age 26, you can stay on your parent's health insurance plan, even if you have access to health insurance benefits elsewhere, even if you don't live with them and even if you are married.

• Shop in a health insurance marketplace

The new health insurance marketplaces, sometimes called exchanges, are selling coverage for next year. You'll have until March 31 to buy a plan for 2014, but you'll need to purchase by Dec. 15 to have coverage start by Jan. 1.

The health plans sold in the marketplaces are provided by private health insurance companies and are standardized to make them easier to compare.

If you don't have access to "affordable" employer-sponsored health insurance, then you might be eligible for a discount, in the form of a federal tax break, on a health plan in the marketplace. The federal government defines "affordable" as a plan where the employee pays no more than 9.5 percent of his or her annual household income for self-only coverage.

You are eligible for a tax credit if you earn up to 400 percent of the federal poverty level -- that's $94,200 for a family of four in 2013. The tax credits are not available for health insurance purchased outside the marketplaces.

You can purchase a marketplace plan online via healthcare.gov, over the phone or by filling out paperwork.

You can also buy a marketplace plan directly through an insurer selling marketplace plans.

• Enroll in a government health insurance plan

You're considered covered if you have Medicare or Medicaid, and your children are covered if they're enrolled in the Children's Health Insurance Program. (See InsureKidsNow.gov for information on that.)

Generally you're eligible for Medicare when you're 65 years or older or if you have a disability or end-stage renal disease. If you're already a Medicare beneficiary, you can change plans for the following year during the open enrollment period, Oct. 15 to Dec. 7. You don't have to do anything if you want to stick with your current Medicare plan.

Turning 65 soon? You have a seven-month period to sign up for Medicare when you become eligible. For instance, that would include the three months before you turn 65, the month of your birthday and the three months after you turn 65. If you don't sign up during that initial period, then you can enroll from Jan. 1 to March 31 of each year.

Medicare health plans are not available through the state health insurance marketplaces. See the federal government's Medicare.gov site for details on the various types of plans available and how to enroll.

More Americans than ever before will qualify for Medicaid in 2014 when eligibility for the program is expanded under the Affordable Care Act. Medicaid eligibility is based on income and family size.

The Children's Health Insurance Program provides low-cost coverage for children of low-income families who earn too much to qualify for Medicaid.

You can find out if you qualify for Medicaid or your children qualify for the Children's Health Insurance Program by filling out an application for coverage through your state's health insurance marketplace.

• Buy directly from a health insurance company

Not all insurers will sell health plans through the state marketplaces. United Healthcare, Humana, Aetna, Cigna and Coventry are among the big names that are staying out of at least some of the marketplaces.

These and other health insurance companies will sell coverage to consumers through their own websites, retail stores, insurance agents and comparison websites (such as Insure.com). Insurers will be able to offer a greater variety of plans and benefits than you'll find in the marketplaces, where plans are standardized.

If you're not eligible for government tax credits for health insurance, then you might find better rates outside the government-run marketplaces. An analysis by HealthPocket, an online company that compares and ranks health plans, found that companies that aren't participating in the marketplaces now offer lower average premiums than other insurers. HealthPocket looked at 2013 premiums of more than 1,600 health plans in 10 states. In nine out of the 10 states, rates for companies that are avoiding the government-run marketplaces averaged 23 percent less than premiums of plans from other insurers.

If the premium trends in the study hold for 2014, then the state marketplaces will have limited appeal for customers who don't qualify for tax credits, HealthPocket said.

• Work with a health insurance agent

Confused about where to turn? Work with an experienced health insurance agent. He or she ca help you compare plans.

Some health insurance agents also sell marketplace plans, but they have to be certified to do so.

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