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Get Covered:
Navigating private and government
health insurance
A project of Consumer Action | www.consumer-action.org
Funded by Consumer Action’s Insurance Education Project © 2019
What you will learn
Health Insurance: Navigating your options
▹ ACA requirements
▹ Marketplace health plans
▹ Non-Marketplace plans
▹ Options for low-income households,
undocumented immigrants and
young adults
▹ Assistance and resources
Affordable Care Act (ACA)
Health Insurance: Navigating your options
✓ Health Insurance
Marketplace
✓ Medicaid expansion
✓ Consumer protections
Health Insurance: Navigating your options
Health Insurance Marketplace
▹ Advance Premium Tax Credit
▹ Cost-sharing subsidy
▹ Qualifying health coverage
Buying a Marketplace plan
Health Insurance: Navigating your options
▹Federal Marketplace or state exchange
▹U.S. citizens or legal residents not eligible for Medicare
▹Open Enrollment or Special Enrollment or Medicaid/CHIP
HealthCare.gov
Tax rates
Choosing a Marketplace plan
Health Insurance: Navigating your options
Plan You pay* Plan pays* Premium
Bronze 40% 60% $
Silver 30% 70% $$
Gold 20% 80% $$$
Platinum 10% 90% $$$$
Catastrophic** >40% <60% $ (< Bronze)
* % of total cost of care, on average
** Only available to those under 30 or with a hardship exemption
Non-Marketplace health plans
Health Insurance: Navigating your options
▹ Insurance company, agent, broker or
online seller
▹ No tax credits or subsidies
▹ Compare total cost, ratings and
network
▹ Major medical plan = ACA-compliant
Short-term health plans: Beware!
Health Insurance: Navigating your options
Low-income gov’t health care
Health Insurance: Navigating your options
Options for undocumented immigrants
Health Insurance: Navigating your options
▹ Off-exchange policy
▹ Health Center Program
▹ Free and charitable clinics
▹ Emergency care
Options for students/young adults
Health Insurance: Navigating your options
Image credit: https://www.healthcare.gov/blog/student-health-insurance-options/
Health Insurance: Navigating your options
Free and discounted
medications for
uninsured and
underinsured patients
Prescription assistance
Assistance and resources
Health Insurance: Navigating your options
▹ HealthCare.gov
▹ Medicaid.gov
▹ HealthFinder.gov
▹ Navigators
▹ HealthInsurance.org
▹ Consumer Action
▹ Nolo
Health Insurance: Navigating your options
Congratulations!
Consumer Action
www.consumer-action.org
415-777-9635
outreach@consumer-action.org
© Consumer Action 2019
You’ve completed the class.

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IndividualHealthInsurance_Slides_2019.ppt

  • 1. Get Covered: Navigating private and government health insurance A project of Consumer Action | www.consumer-action.org Funded by Consumer Action’s Insurance Education Project © 2019
  • 2. What you will learn Health Insurance: Navigating your options ▹ ACA requirements ▹ Marketplace health plans ▹ Non-Marketplace plans ▹ Options for low-income households, undocumented immigrants and young adults ▹ Assistance and resources
  • 3. Affordable Care Act (ACA) Health Insurance: Navigating your options ✓ Health Insurance Marketplace ✓ Medicaid expansion ✓ Consumer protections
  • 4. Health Insurance: Navigating your options Health Insurance Marketplace ▹ Advance Premium Tax Credit ▹ Cost-sharing subsidy ▹ Qualifying health coverage
  • 5. Buying a Marketplace plan Health Insurance: Navigating your options ▹Federal Marketplace or state exchange ▹U.S. citizens or legal residents not eligible for Medicare ▹Open Enrollment or Special Enrollment or Medicaid/CHIP HealthCare.gov
  • 6. Tax rates Choosing a Marketplace plan Health Insurance: Navigating your options Plan You pay* Plan pays* Premium Bronze 40% 60% $ Silver 30% 70% $$ Gold 20% 80% $$$ Platinum 10% 90% $$$$ Catastrophic** >40% <60% $ (< Bronze) * % of total cost of care, on average ** Only available to those under 30 or with a hardship exemption
  • 7. Non-Marketplace health plans Health Insurance: Navigating your options ▹ Insurance company, agent, broker or online seller ▹ No tax credits or subsidies ▹ Compare total cost, ratings and network ▹ Major medical plan = ACA-compliant
  • 8. Short-term health plans: Beware! Health Insurance: Navigating your options
  • 9. Low-income gov’t health care Health Insurance: Navigating your options
  • 10. Options for undocumented immigrants Health Insurance: Navigating your options ▹ Off-exchange policy ▹ Health Center Program ▹ Free and charitable clinics ▹ Emergency care
  • 11. Options for students/young adults Health Insurance: Navigating your options Image credit: https://www.healthcare.gov/blog/student-health-insurance-options/
  • 12. Health Insurance: Navigating your options Free and discounted medications for uninsured and underinsured patients Prescription assistance
  • 13. Assistance and resources Health Insurance: Navigating your options ▹ HealthCare.gov ▹ Medicaid.gov ▹ HealthFinder.gov ▹ Navigators ▹ HealthInsurance.org ▹ Consumer Action ▹ Nolo
  • 14. Health Insurance: Navigating your options Congratulations! Consumer Action www.consumer-action.org 415-777-9635 outreach@consumer-action.org © Consumer Action 2019 You’ve completed the class.