Marketplace health insurance plans

As of the 1st October 2013  the health insurance marketplaces(*Exchanges) run by state or federal authorities will offer Qualified Health Plans (QHPs) that will be the same high-quality health plans available on the private market.

These QHPs will provide the essential levels of coverage and comply with consumer protections set forth in the Affordable Care Act and will include a “catastrophic coverage” designed for people aged up to 30.

Exchange Functions include:

• Certifying, recertifying & decertifying QHPs
• Establishing a toll free hotline
• Creating an internet website
• Rating qualified health plans
• Providing standardized information on benefits
• Screening and enrolling into the Exchange, Medicaid, & CHIP

In order for those individuals/families without coverage to get quotes for the PPACA compatible health insurance coverage they can go to the marketplaces(Exchanges) which will open 10/1/2013.

There will be 5 different health plans in the marketplaces – which will offer plans created and offered by the usual health insurance companies like Humana, Aetna, Healthet, BC/BS, UHC,etc.- run by either the state or federal authorities:-

1) A Catastrophic plan for anyone age up to 30 which will have limited physicians and specialists office visits ( we are still waiting for full details) and catering to young people who do not want or wont pay for a fully fledged medical plan- they all believe themselves to be invulnerable of course.

B) -4 different, full, health ,metal designated plans with various deductibles:
Platinum 90% (Actuarial Value),
Gold 80%(AV),
Silver 70% (AV) and
Bronze 60%(AV)

AV is not the same as the % of Coinsurance we usually see when talking about health insurance plans -like 80/20, 70/30, etc.but are fairly close to it but of course as the % of coinsurance or AV goes up the premiums will also increase.These plans will also have different deductibles,etc.

The applicants will also be able to get indications of what tax credits for the monthly premiums and and cost sharing contributions for the copays, deductibles, etc required under their policies will be available under PPACA and paid for by the government.

Tax Credit calculator

This calculator will allow you to calculate an estimate of the tax credit amount you might be able to get from the federal government for the Silver level health plan on the new marketplaces/exchanges and ready to use 10/1/2013 for health plan coverage which will start 1/1/2014!

about this tool

This tool illustrates health insurance premiums and subsidies for people purchasing insurance on their own in new health insurance marketplaces/exchanges created by the Affordable Care Act (PPACA). Beginning in October 2013, middle-income people under age 65, who are not eligible for coverage through their employer, Medicaid, or Medicare, can apply for tax credit subsidies available through state-based exchanges.

Additionally, states have the option to expand their Medicaid programs to cover all people making up to 138% of the federal poverty level (which is about $33,000 for a family of four). In states that opt out of expanding Medicaid, some people making below this amount will still be eligible for Medicaid, some will be eligible for subsidized coverage through Marketplaces, and others will not be eligible for subsidies.

Arizona, of course. agreed to expand its Medicaid program (AHCCCS )

With this Kaiser Family Foundation calculator, you can enter different income levels, ages, and family sizes to get an estimate of your eligibility for subsidies and how much you could spend on health insurance. As premiums and eligibility requirements may vary, contact your qualified insurance agent/broker or state’s Medicaid office or exchange with enrollment questions.

REMEMBER- the Health Insurance Marketplaces ( the Exchanges) will be open November, 1st 2019  through 12/15/2019 (Enrollment Period) for health insurance coverage to start 1/1/2020 and you can use a qualified insurance agent/broker at no cost to you to help you!!

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