Are you feeling stressed out by all the TV coverage and news articles telling you how bad the new health insurance rules are or how great they are depending on who you talk to? Exchanges, subsidies and penalties oh my!
Take a deep breath, its going to be okay. I'll give you the basics for free! I am licensed in Indiana so I'm going to talk about the set up here, if you are in a different state you will need to talk with someone in that state to be sure how it will work for you. Are you ready? Here we go!
First if you have a policy and you've not gotten a cancelation notice it means for now your current policy and network will remain the same. You can keep it for a year and maybe longer, but that is not set in stone. If you have a policy and have received a cancelation notice, it means your policy must be changed to comply with the new law and it was not grandfathered in for some reason. You will need to get a new ACA policy (ACA stands fro the Affordable Care Act, which is a misnomer because it doesn't make coverage more affordable it just gives subsidies for those that make less money).
In Indiana you have 5 basic choices depending on your age situation and income. I'll run through the first three quickly because they are very limited choices.
1. Medicaid - If you qualify for Medicaid it satisfies the ACA requirements.
2. Employer plans - If your employer has a group plan available to you that costs less than
9.5% of your income then you need to stay with it.
3. CHIP - This is for children of lower income families that don't qualify Medicaid.
Okay so for the other two options ... you can buy an individual plan through an insurance company direct or you can buy the same plan from the federally facilitated marketplace (commonly called the exchange). Both plans could offer identical coverage but there are two very noteworthy differences.
1. Plans purchased through the exchange will most likely have a much smaller network than those purchased directly from the insurance company. So you may not get to use your current doctors or hospitals.
2. Plans purchased through the exchange may qualify for a federal subsidy to offset the cost of the insurance. Plans bought directly from the insurance company are not qualified for a subsidy.
The bottom line is that the law is requiring you to get some basic health coverage. If you are at or below the poverty line you will have access to Medicaid, and if you make above the poverty line (up to 400% of that amount) you may qualify for a subsidy that can pay for most or part of your health insurance costs, but if you choose either of these options you'll just have a limited number of options for doctors and hospitals.
You can make an appointment with me to go over your options but do it quick, because you only have a small window to enroll before you'll be forced into a higher cost option while waiting on open enrollment.
Jason
I forgot to say that if you are over 65 you will have Medicare.
ReplyDeleteJ