Have you heard of the Affordable Care Act? Also called, ACA or Obamacare? Wondering more about it? It will be important to be prepared for this fall as the Health Insurance Marketplace starts Oct. 1, 2013.
What is the Health Insurance Marketplace? Starting this fall, the online Health Insurance Marketplace, also called an Exchange, will be the place to find affordable private insurance plans approved by the federal government. The Marketplace will be on the website www.healthcare.gov. It is a new option for people who have not been able to get affordable insurance through their work or buy it on their own. People will be able to compare insurance options and choose a plan that is right for them. (It is not for people eligible for Medicare.)
Why should you care about the Marketplace? The new health reform law requires that everyone who can afford health insurance must buy it, or may have to pay a tax fine. The
Marketplace will help you find a plan more easily and make buying that health insurance more affordable.
The definition of an affordable health insurance plan is based on how much of your income the premium (cost to buy the plan) makes up. Premiums will cost between 2 percent and 9.5 percent of your total income in the Marketplace. A premium that costs more than 9.5 percent of your income is considered unaffordable and you will not be taxed if you do not buy a plan.
Who can buy health insurance on the Marketplace? Only US citizens or residents who live in the United States, and have no access to affordable employer insurance or Medicare may buy health insurance on the Marketplace. People in prison may not. If you already have insurance through Medicare, Medicaid, or an employer, you may keep your current insurance.
How does the Marketplace work? The federal government is working with private insurers to decide which health insurance plans will be in the Marketplace. People will see which insurance plans are available Oct. 1, 2013. There will be four different levels of insurance plans: Bronze, Silver, Gold and Platinum.
Plans will be different depending on which health care providers you see, what benefits are covered, how much you pay for premiums, and how much you pay out-of-pocket each time you use a service. Platinum plans will cover the most health services and be the most expensive.
All plans will cover basic or "essential health benefits" required by the health reform law.
How do I use the Marketplace? You will be able to look at health insurance plans online and apply for health insurance in the Marketplace in several ways. Applications can be submitted online, by mail or by calling a help center.
Page 2 of 2 - In late Summer 2013, a national 24-hour call center will open to answer questions and help with understanding the different health insurance plans and eligibility. Local resources called Navigators can also be contacted to answer questions and provide more in-person information. You can also chat online with Marketplace representatives.
The health insurance will cover health care services received between Jan. 1, 2014, and Dec. 31, 2014. You will be able to sign up for health insurance from Oct. 1, 2013, through March 31, 2014. You must renew your coverage or enroll in a new health insurance plan each year.
Will I get help paying for premiums and other costs? If your income is low enough, you may be eligible for lower premium costs, or discounts, through tax credits or premium subsidies. The discount is automatically figured when you apply.
You are eligible for this discount if your income is between $11,490 and $34,470 for a single person, or $23,550 and $92,400 for a family of four. These incomes are based on the federal poverty level, which also account for family size.
Also, if your income is low, you may not have to pay the full co-payment for care or services.
You can learn more at www.healthcare.gov Educational sessions will be offered through the McPherson County Extension Office. The Affordable Care Act is not going to go away; so the more you know about it, the better.
Jana McKinney is a McPherson County Extension agent for family and consumer sciences