McPhersonSentinel - McPherson, KS
  • Deadline nears to purchase insurance for Jan. 1 coverage

  • The deadline is drawing near for those wishing to have insurance coverage through the federal marketplace starting Jan. 1.
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    • By the numbers
      355,069 — number of uninsured people in Kansas
      1,553 — estimated number of uninsured in McPherson
      $1,271 —average bill for a three-day hospital stay in McPhe...
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      By the numbers
      355,069 — number of uninsured people in Kansas

      1,553 — estimated number of uninsured in McPherson

      $1,271 —average bill for a three-day hospital stay in McPherson Hospital. (room cost only)

      Websites to know

      - healthcare.gov — official federal marketplace website. This is where you can go to enroll.

      Other sites that may provide helpful information

      - insureks.org

      - hrsa.gov

      - ksinsurance.org

      - healthsherpa.org

      - kff.org

      Phone number to know


      Healthcare.gov hotline

      Dates to know

      - Dec. 23 — Last day to enroll to be covered by Jan. 1

      - March 31 — Last day to enroll to avoid a penalty

      What they have to offer you

      Essential health benefits covered by all insurance plans in the marketplace:

      - Doctor or clinic visits.

      - Emergency department care

      - Hospital care

      - Maternity and new baby care

      - Mental health, behavioral health and substance abuse treatment

      - Prescription medication

      - Rehabilitation and habitation services and devices

      - Lab tests

      - Prevention and wellness service and chronic disease management

      - Children's care, including dentist and eye care
  • The deadline is drawing near for those wishing to have insurance coverage through the federal marketplace starting Jan. 1.
    Applicants must apply by Monday if they want to have coverage start at the first of the year.
    Open enrollment continues through March 31, and the uninsured can avoid penalties by signing up by that date. However, delaying application will delay the start of insurance benefits.
    McPherson County K-State Extension sponsored an information night for people interesting in learning more about the Affordable Care Act and the federal exchange Tuesday night.
    Jana McKinney, extension agent, as well navigator Christina Bachman of Salina, presented.
    Who can apply
    Americans who can't access affordable health care through their employers and are not covered by Medicare can apply for insurance through one of the insurance exchanges. Bachman said many think their work insurance policies are not affordable, but the government defines affordability based on a percentage of a person's income. For one person, the policy has to cost 9.5 percent of the annual household income or less. If health insurance will cost more than 8 percent of the household income, a person can request a hardship waiver that will prevent the federal tax penalty.
    The penalty
    The penalty for not being insured in 2014 will be $47.50 per child per year and $95 per adult per year. The maximum penalty per family using this method is $285. The penalty can also be figured based on 1 percent of the household income with the maximum penalty being the yearly premium of a bronze insurance plan.
    These penalties are set to increase in 2015 and 2016.
    Kansas did not create its own insurance exchange, so Kansans can apply through the federal marketplace exchange.
    The two companies offering marketplace insurance in Kansas are Blue Cross/Blue Shield and Coventry.
    How to apply
    People can apply in person, online, on paper or by phone.
    Although you can apply on paper, Bachman said you may have to wait four to six months to have your application processed.
    The plans
    There are four levels of insurance available through the federal system plus a catastrophic plan that can be purchased by people up to the age of 30. The catastrophic plan has very limited coverage, but would kick in if a person had a major injury or illness. The four levels are bronze, silver, gold and platinum. Different plans have different co-insurance amounts, deductibles and co-pays. Co-insurance is your share of a health care expense calculated as a percentage. For example the gold plans require you to pay 20 percent of your health services costs. A deductible is what you pay before your insurance starts to pay the bills. Co-pays are fixed expenses for a service you usually pay at the time of service. For example, you may pay $25 for a doctor's visit.
    Page 2 of 2 - Tax credits
    For those who can apply for insurance through the health care exchanges, individuals and families whose household incomes are between 100 and 400 percent of the federal poverty level may receive tax credits to help pay for their insurance. People who are receiving insurance through their employers are not eligible for these credits. People can only be eligible for tax credits if they seek insurance through the marketplaces.
    The tax credit payments will generally go directly to the insurance company to reduce the insured person's payments.
    People applying for insurance through the marketplaces have to assume some personal responsibilities. These include making the best estimate of their income for the year. An inaccurate estimate could result in you owing the federal government for an overpayment of tax credits or you receiving a tax refund at the end of the year.
    You have to inform the marketplace if you have a increase or decrease in income throughout the year.
    You must file for a hardship exemption if you qualify for one.
    If you fall below the poverty line, the federal marketplace will direct you to apply for Medicaid. However, Kansas was one of 25 states that choose not to expand Medicaid in 2014. This means tens of thousands of people will be left uninsured.
    Consumer Protection
    The Affordable Care Act also changes some insurance rules to protect consumers. The are as follow:
    - No one can be denied coverage based on a pre-existing condition.
    - People are guaranteed reissuance and renewal of their policies.
    - There are no lifetime limits on coverage.
    - Out-of-pocket expenses are limited to $6,350 for individuals and $12,700 for families.
    Finding help
    As a navigator, Bachman is certified to assist people apply for insurance through the marketplace. People can call her, email her or make an appointment to see her in person. Her office is at Salina Family Healthcare Center, 651 E. Prescott, Salina, KS 67401. Call her at 785-825-7251 or email her at cmbachman@salinahealth.org.
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