Are You Confused
Here are 10 Things To
Know About Health
The start of
for the new health
insurance marketplace is six
weeks away, and perhaps you've
got questions. Such as: How will it
affect you, and should you be
doing anything to get ready now?
Answers to what people have been
asking about the start of
enrollment in the marketplace,
set for Oct. 1, 2013, in some of
these 10 basic things to know:
1) The Affordable
Care Act requires
nearly everyone to
have health insurance starting
Jan. 1, 2014, or pay a financial
This applies to you, unless you
•— In prison.
•— An undocumented immigrant.
•— Earning too little to file a tax
•— Accepting health insurance is
against your religion.
•— You'd have to pay more than 8
percent of your income for
insurance after counting what
your employer contributes and
any tax credits you'd receive for a
health plan through the state
2) Coverage for the uninsured will
be accessed through the new
Formerly called the health exchange,
this is the umbrella under which
different health plans are being
made available to individuals,
families and small businesses.
Through the marketplace, you can
review health plans that are
available and access coverage and
3) Who needs to pay attention to
the marketplace and upcoming
enrollment? Basically, anyone
who is uninsured and under 65.
Most people are covered under
employer health plans and will
continue with that form of
If you're on Medicare, note: It
isn't part of the health insurance
marketplace, and the
marketplace won't affect
Medicare choices and benefits.
4) How much will marketplace
plan rates cost?
That is still unknown.
Information on rates and plans
hasn't been released, and there
isn't a date yet for when it will be
available, according to state
Department of Insurance
spokeswoman Kimberly Parker.
5) What financial assistance is
available for health coverage?
Tax credits will be available to
help anyone with a household
income at 139-400 percent of the
federal poverty level. That's an
income of $15,500 to $44,680 for an
individual and $32,000 to $92,200
for a family of four.
Applicants will have three options
for subsidy payments. They'll be
able to take them monthly to be
directly applied toward their
premium payments or at the end
of the year, or have them applied
toward partial monthly premium
assistance, with the rest paid at
the end of the year.
Health plans will be available in
four categories of cost-sharing
levels called bronze, silver, gold
and platinum. People with an
income at the low end, 139-200
percent of the federal poverty
level, will also eligible to apply for
cost sharing on one of the silver-
level plans that will lower their
6) What if your income is even
less than 138 percent of the
federal poverty level?
You will be directed to apply for
coverage under the expanded
state Medicaid (public insurance)
Don't worry about which one you
qualify for, marketplace or
Medicaid. You apply for both
through the marketplace, and
once you provide your income
information, you'll be directed
NOTE: If you qualify for Medicaid,
you won't be able to receive
financial assistance for a
marketplace health plan.
Are You Confused Yet?
7) Can you still apply for
marketplace coverage if you earn
more than 400 percent of the
federal poverty level?
Yes, but you won't be eligible for
People with coverage meeting
certain standards through their
employers are also ineligible for
the tax credits.
I urge people currently buying
individual coverage (not through
their employers) to check out the
plans and rates on the marketplace,
even if they are going to be ineligible
The coverage and rates on plans in
the marketplace may be a better
deal, and comparisons should be
simple to make online!
The above website you can obtain
a FREE quote from multiple
8) I am an adult with a pre-
existing health condition. Can I
enroll in a marketplace plan?
Yes. Under the Affordable Care Act, it
is already illegal for insurers to
discriminate against children with
pre-existing conditions, and starting
next year, the same protection will be
in effect for adults.
9) What should you do to get ready
•— Take a look at your budget.
•— Prepare what questions you may
have about coverage. Help will be
available on the phone and through
in-person assistance being made
available starting Oct. 1, 2013 at
various locations, among them
public health departments.
Health Care Consumers will also
be available to answer questions.
— Start gathering your financial
paperwork. Among what you'll
need: Family members' Social
Security numbers and
information about your family
income, such as pay stubs.
10) Where can I learn more?
— Check out sample applications
and learn more about the
Multiple health insurance