Thanks to ObamaCare, Minnesotans who don’t have insurance or have, but are not satisfied with it, now have new rights, protections and benefits.
- The bill brings an end to discrimination for pre-existing conditions. Insurers can no longer deny coverage or charge more because of a pre-existing condition.
- ObamaCare covers preventive services with no deductible or co-pay.
- The ACA removes lifetime limits on health benefits.
- ObamaCare brings new coverage options for young adults. If your plan covers children, you can keep them in your health insurance policy until they are 26 years old.
The official ObamaCare enrollment period ended on March 31, 2014. Important Notice: Its urgent, to avoid future fines and penalties, to sign up for health insurance under the Affordable Health Care Act.
Minnesota Individuals & Families: Find out the most cost efficient healthcare insurance for you.
This is possible through the new online Health Insurance Marketplace also known as Exchange.
The Exchange provides individuals, families and small businesses, who don’t have insurance, a new way to find health coverage that fits their needs and their budgets.
The Health Insurance Marketplace makes it easy to compare plans, find out if you are eligible for lower costs, and enroll.
The health care law provides better options, better value and better health to the people of Minnesota.
- The Affordable Care Act requires that 80-85 cents of every dollar you pay for health insurance is spent on delivering or improving health care or you get a refund from your insurance company.
- Insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more.
- It Increases support for community health centers nationwide.
- ObamaCare invests in the primary care workforce.
The Marketplace offers:
- This is the lowest cost plan available.
- It has the lowest premiums and the lowest actuarial value.
- The actuarial value of a bronze plan is 60%. This means that 60% of medical costs are paid for by the insurance company, leaving the other 40% to be paid by you.
- This is the second lowest cost plan.
- It has an actuarial value of 70%. This means that 70% of medical costs are paid for by the insurance company, leaving the other 30% to be paid by you.
- This is the second most expensive plan.
- It has an actuarial value of 80%. This means that 80% of medical costs are paid for by the insurance company, leaving the other 20% to be paid by you.
- This is the plan with the highest premiums.
- The Platinum plan as an actuarial value of 90%. This means that 90% of medical costs are paid for by the insurance company, leaving the other 10% to be paid by you.
- These are plans for people under 30.
- They usually have high deductibles, essential benefits and low premiums.
The Marketplace in Minnesota also offers dental plans for children and families.
There is an extensive list of provider networks that offer health insurance plans, but they are subject to change. You should contact your insurer directly.
You can check provider networks for individuals and families at the Minnesota ObamaCare exchange.
You can check provider networks for small businesses at MNSure.org
What if I can’t afford coverage?
You may qualify for MA or MinnesotaCare, or for a tax credit and payment assistance to lower your cost.
Medical Assistance and MinnesotaCare
Medical Assistance and MinnesotaCare are health care programs for low-income residents (children and parents, adults without children, people with disabilities and seniors) who fall within the Minnesota Health Care Programs (MHCP).
If you qualify for MA or MinnesotaCare, you will be able to get medical services at little cost to you.
Medical Assistance does not have a premium (monthly fee). Members do have small co-pays for some services, usually $1 – $3. This is called cost sharing.
MinnesotaCare does have a premium (monthly fee), based on your income, and small co-pays.
- Individuals with annual incomes of up to $15,282 qualify for MA
- All children and pregnant women up to 275 % of the federal poverty level are eligible for MA
- Individuals with annual incomes of $15,282 to $22,980 qualify for MinnesotaCare.
You can find more information about cost sharing and what MHCP covers by visiting the states website.
Individuals with annual incomes of $22,981 to $45,960 qualify for tax credits that can be used immediately to lower your premiums.
The amount of tax credit available to individuals and families depends on modified adjusted gross income, age and geographic area. * For most taxpayers, the household Modified Adjusted Gross Income (MAGI) is the same as Adjusted Gross Income (AGI) which can be found on Line 4 on a Form 1040EZ, Line 21 on a Form 1040A, or Line 37 on a Form 1040.
Premium assistance is calculated based on where an individual’s annual income falls on the Federal Poverty Level (FPL) table. To check the table please visit the states Health Insurance Exchange.
If you qualify for the tax credit, you can choose:
- In advance to reduce your health care plan costs each month (You can begin receiving the tax credit when your coverage becomes effective).
- Apply for it when you file your federal tax return.
You may also qualify for extra savings through cost-sharing assistance. This help reduces the amount you pay of put-of-pocket costs.
The federal government provides this assistance usually to:
- Individuals earning up to $28,725
- Families of 4 earning up to $58,875
The Tax Penalty
If someone can afford health insurance and decides not to have coverage in 2014, they may have to pay a fee also known as Tax Penalty. The penalty can be any of the options explained below (whichever is higher):
- 1% of your yearly household income.
- $95 per person for the year ($47.50 per child under 18).
*This fee increases every year.
*If you’re uninsured for less than 3 months, you don’t have a make a payment.
To avoid the fee you need insurance that qualifies as Minimum Essential Coverage.
You’re considered covered and don’t have to pay a penalty if you have any of the following:
- A Marketplace plan.
- An individual insurance plan.
- Any employer plan with or without “grandfathered” status.
- The Children’s Health Insurance Program (CHIP).
- Veteran health care programs.
- Peace Corps Volunteer plans.
Some people are exempted from the fee.
- Individuals and families below a certain income
- People who cannot afford the coverage that is available
- Individuals who have been uninsured for less than three months
- Members of American Indian tribes
- People who do not obtain coverage because of religious objection
To apply for an exemption, you have two options:
- through MNsure via an interface with the federal system (once it is available)
- through the IRS when you file your 2014 taxes
To check and compare health insurance plans visit the Marketplace at MNsure.org