Issue link: http://accesshealth.uberflip.com/i/198435
4/ accessHealthnews.net Fall/Winter 2013 Marketplace Q&A U.S. Dept. of Health & Human Services accessHealth Staff a 21-year-old woman would no longer be charged more than a man her same age. If that 21year-old decided to carry only catastrophic coverage, it would cost just $95 a month. This catastrophic plan would cover medical bills only after he or she incurs $6,350 in medical bills during the year. However, it would also provide free preventive services like vaccinations, routine screenings and contraception. The policy would also ensure that 21-year-old would not go broke if he or she is seriously injured. accessHealth interviews Stephene Moore, RN, BSN - Regional Director with U.S. Department of Health & Human Services, Region VII Q: What are the 3 biggest myths about the Marketplace? A. Myth #1: The cost of insurance is going up. The prices that are now available are significantly less expensive than the projections made early this year. In Kansas City, for example, a 40-year-old can get a bronzelevel plan for as little as $183 a month. And if that applicant has income of $26,000, he can get discounts that allow him to buy that policy for just $100 a month. So these plans are far more affordable–and provide more coverage–than plans offered in the current, individual market. fairness. When people go without insurance, they are attempting to 'free-ride' on our health care system. A study in 2011 found that when uninsured patients are admitted to the hospital, they walk away from all or part of their bills 95 percent of the time. The cost of treating those patients gets passed on to others and pushes up the cost of medical care and the cost of health insurance for everyone else. The Affordable Care Act is working to make health insurance available and affordable for everyone. Therefore, everyone has to do their part. There is no requirement to carry health insurance. But if you choose to go without insurance, you are required to contribute to the health care system through an extra tax. This tax is minor the first year, just to get your attention. It is a minimum of $95 per adult in the household, plus half that amount per child, or 1 percent of the household's income. The minimum penalty goes to $325 per adult in 2015 and to $695 in 2016. Myth #2: If you're healthy, you don't need insurance. Everyone is healthy right up to the moment when they are not. No one plans that sports injury or that car wreck or that cancer diagnosis. But when it happens, you need treatment immediately and For people who choose to enroll insurance makes that possible. in health insurance through the Health Insurance Myth #3: Signing up for insurance new Marketplaces, discounts based on is really complicated. Creating an person's income are online account and filling out the each available. For many people with online application is simple. If you have questions, you can contact modest income, these discounts the call center at 1-800-318- mean that they would pay less 2596. You can also find a list of each month for insurance than nearby places where you can get they would pay in penalties. in-person help with no charge. Once we are past the initial glitches in the website software, people will realize how simple the process really is. Q: Because Missouri didn't expand Medicaid, some people won't be able to purchase insurance on the Marketplace. Please confirm where these Q: Why shouldn't the individuals fit within the individual penalty stall for one Federal Poverty Level (FPL) and what their options are. year? A: The reason these penalties A: People whose income is below should not be suspended is about the poverty level are not eligible Q: HealthCare.gov, for the most part, has been out of commission. Considering the for the credits that provide technical issues, how can discounts on insurance purchased people still enroll? through the Marketplace. These residents were supposed to be A: In the first four days, 8.6 eligible for Medicaid, which is a million unique visitors went to the state-federal program that pays healthcare.gov site. That's more for medical treatment for the than the number who visit the poor. Southwest Airlines site in a month. The call center received 406,000 In Missouri, only very poor people calls and the staff received with children, pregnant women 225,000 questions through the and a few other categories qualify online chat feature. About onefor coverage from Medicaid. The third of the visitors were able to health reform law required states access information about health to expand their Medicaid to cover insurance using the online people up to 133 percent of the Marketplace. Others were able to poverty level. So everyone living complete the account set-up below the poverty level would get process. However, we also realize coverage. that many people were frustrated by the slow response times or by However, the U.S. Supreme Court error messages that prevented ruled that states have the option them from completing the of whether to expand Medicaid application. eligibility. The Missouri legislature did not expand eligibility for the In recent days, the department state Medicaid program, so people has increased server capacity to living below the poverty level, handle more customers. $11,490 a year for an individual, Additional staff has been assigned or $19,530 for a family of three, to install an improved system are not eligible for discounted configuration to handle more insurance. These people were left volume and shorten wait times. out by the Missouri legislature's Few technology launches are decision not to expand Medicaid glitch-free. eligibility. People should remember that The options available include there is no reason to rush into a safety-net medical providers that decision about health plan options. charge fees based on the patient's As long as you sign up by Dec. 15, income. Clinics such as the KC your coverage can begin on Jan. Care Clinic in Midtown Kansas City 1. So please be patient, consider and community health centers your options and take the time to such as Samuel U. Rodgers Health make the best decision. Center and Swope Health Services provide high-quality care. Q: How do you file a waiver to avoid the penalty? Q: The "young, invincibles" need health coverage, too. A: People facing financial hardship How affordable is the or whose income is below the marketplace for the young and poverty level can apply for a healthy? waiver through the Marketplace website. They provide income A: In the Kansas City area, a information, choose the waiver 21-year-old can buy a bronze- option and the Marketplace makes level plan for just $144 a month. a preliminary determination on That policy would pay, on the applicant's eligibility for a average, for 60 percent of that waiver.