Friday, October 31, 2014

MCFARLAND: Affordable Care Act in Kansas

By REBECCA MCFARLAND, Reaching Out | 6/28/2013

In a little more than three months from now, the “marketplace” will be open. 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 new health reform law requires that everyone who can afford health insurance must buy it, or they might 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 new 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. If your income is low enough, you might 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 might not have to pay the full co-payment for care or services.

In a little more than three months from now, the “marketplace” will be open. 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 new health reform law requires that everyone who can afford health insurance must buy it, or they might 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 new 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. If your income is low enough, you might 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 might not have to pay the full co-payment for care or services.

Only U.S. 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. If you already have insurance through Medicare, Medicaid or an employer, you may keep your current insurance.

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 may 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.

Essential Health Benefits include:

• Doctor or clinic visits

• Emergency department care

• Hospital care

• Maternity and new baby care

• Mental health, behavioral health and substance abuse treatment

• Prescription medicine

• Rehabilitation and habilitation services and devices

• Lab tests

• Prevention and wellness services, and chronic disease management (like asthma and diabetes)

• Children’s care, including dentist visits and eye care (glasses)

To learn more about The Affordable Care Act and the Marketplace, go to www.healthcare.gov

We also will have more information, as it becomes available, on our website www.frontierdistrict.ksu.edu and at both our Lyndon and Ottawa offices.  

Rebecca McFarland is the family and consumer sciences extension agent for Frontier Extension District No. 11, which serves Franklin County. For more information, call her at (785) 229-3520 or email rmcfarla@ksu.edu

comments powered by Disqus