Health insurance can be confusing, particularly for people who've never had it before. There is so much terminology to learn and many different plans to from which to choose. Below we try to help break it down for you.
Where to go for help?
The Kansas Association for the Medically Underserved (KAMU) is organizing the state's largest effort train counselors called "navigators" to provide one-on-one guidance through the government's online enrollment site known as the "exchange" or the "marketplace". These navigators will help explain different policy options and check if your income qualifies for subsidies. The Kansas Insurance Department has also set up an interactive website to walk people through the enrollment process. The goal is to give you a clear understanding of the differences in plans and an estimate of your total cost for coverage.
Coverage isn't free
Even the poorest participants will have to make a small monthly payment toward their health insurance. That amount will be determined by your income relative to the federal poverty level.
Tax credits, or subsidies, are available for those who earn between 100% and 400% of the federal poverty level. For a family of four that's between $23,550 and $94,200. The more you make, the smaller your subsidy.
Types of coverage
In Kansas, ACA coverage will be offered through two providers, Blue Cross/Blue Shield of Kansas and Aetna, which recently absorbed Coventry.
There are four tiers of plans, bronze, silver, gold and platinum. The lower tiers may have lower monthly premiums and higher out of pocket expenses. The Gold and Platinum plans cost more upfront, with lower out of pocket expenses later.
Cost for coverage
Example: A family of four in Sedgwick County with a husband & wife in their mid 30s and a total income of $50,000 can expect a total monthly premium of $562 for a silver plan. That family is eligible for an advance tax credit of $282, which brings their monthly out of pocket expense to $280.