Tuesday may be a big day in the lives of individuals that have been looking forward to the opening of Health Insurance Exchanges. We invited Jeff Romine, partner with the Financial Planners of Missouri to the set of Good Morning Heartland to break it down for us.
Question: Can you help the viewers understand these exchanges?
Answer: First, it is important for the viewers to know that the government is not in the health care business. Instead, the law requires that individuals acquire health insurance. As a consumer, you can select whatever company you want. As a result of the Patient Protection and Affordable Care Act (ACA) that was passed in 2010, each State will have Health Benefit Exchanges for individuals. The general purpose of these Exchanges is to make it possible for consumers to compare health plans, get answers to questions, and enroll in a health plan that is both cost effective and meets their health needs. The US Department of Health and Human Services estimates that about 800,000 Missourians are eligible to use this program.These exchanges are not issuers of health insurance but are designed to bring buyers and sellers of health insurance together electronically, with the goal of increasing access to affordable coverage. The exchanges will not be sharing information about Medicare supplemental insurance
Question: Who is going to benefit from these exchanges?
Answer: Beginning in 2014, most individuals, with a few exceptions, are required to have health insurance. Everyone will not need the exchanges, but individuals who do not have insurance or who buy it on their own should be looking at the exchanges and making a decision by December 15, 2013 so that they have health insurance on January 1 2014. It is important that individuals be aware of their situation because the failure to comply with this requirement potentially results in a tax penalty.
Question: Who is eligible to participate in an exchange?
Answer: You must be a U.S. citizen, national, or noncitizen lawfully present in the United States. You cannot be incarcerated. You must meet applicable state residency standards.
Question: Who is operating these exchanges?
Answer: States have the option of running their own state-based Exchange or partnering with the federal government to operate a federally facilitated Exchange. In Missouri the Federal government will be making the final decision about which insurers will sell health insurance policies in the State. In a recent article, the private insurance companies: Anthem Blue Cross and Blue Shield of Missouri, Blue Cross Blue Shield of Kansas City, Centene, and Coventry were identified as possible participants, but we wonâ??t know until we see the list that should be available now.
Question: There has been a lot of confusion about this topic. Why is that?
Answer: This topic is unusual in that it is quite complicated, represents a change never before experienced by the citizens of the U.S., and accordingly the topic is highly political. There have been numerous efforts to stop it from going forward, plus there are individuals laboring to stop it as we speak, so it is hard to know what will happen in months and years to come.
Question: How does one access the exchanges?
Answer: To access the health insurance exchanges, you have to go online to healthcare.gov and click on the appropriate state. Then you will be prompted to answer questions. After responding to the questions, you will learn about the companies that are making insurance available and the cost of insurance for you for four different levels of coverage: bronze, silver, gold and platinum. The less expensive plans typically have higher deductibles and larger co-payments.
Question: Will one have to give up their current health-insurance?
Answer: If you have health insurance through your employer, or you have private insurance, you'll most likely be able to keep your present coverage. You are not required to take any action. Also, you may benefit from an expansion in coverage for adult dependents to age 26 and with the removal of any lifetime dollar cost limits. Moreover, your insurance can not be cancelled if you become sick, and your plan cannot refuse to insure you if you have a pre-existing medical condition.
Question: Will small businesses have to provide insurance to their employees?
Answer: If you are a small business owner with fewer than 50 full-time equivalent employees, you are not required to provide health insurance to your employees. These employees may need to use the exchanges to find insurance for them and their family.
Question: Does the ACA provide financial subsidies to people with limited resources?
Answer: Yes, if you have income between 100% and 400% of the poverty level, you can get some help paying premiums. A family of four can with income up to $90,000 can get a subsidy. Individuals with income less than 250% of the poverty level can also get help with deductibles and copayments.
Question: Will individuals have to pay taxes on their health benefits?
Answer: Nothing in the health-care law requires individuals to pay income taxes on their health-care benefits.
Question: Will ACA promote end-of-life decisions for seniors?
Answer: There is nothing in the ACA in its final form, which forces seniors to have consultations about end-of-life choices.
Question: Will the health-care law lead to government takeover of health care?
Answer: This may be the heart of the political controversy. While provisions of the health-care law place some responsibility on the government to ensure that qualified insurance is available to most individuals, there is nothing in the law that directly promotes government takeover of our health-care system.
Question: Will the new health care law cause an increase in health-care scams?
Answer: Probably, be careful with your bank account and credit card numbers and never give your Social Security number to anyone you don't know.For instance, you may get a call, e-mail, or visit from someone claiming that if you don't have health insurance, you'll go to jail. These same scammers may claim to be government officials and offer to sell you qualifying health insurance. Their goal is to get unsuspecting and frightened individuals, particularly seniors, to divulge personal information.To protect yourself, never buy insurance without checking with your state insurance department to be sure the seller is licensed and the policy is legitimate. Don't give out your credit card or bank card information, and don't give your Social Security number to anyone you don't know.
Financial Planners of Missouri
IMPORTANT DISCLOSURES: Source of some of the information: Broadridge Investor Communication Solutions, Inc.This material does not provide investment, tax, or legal advice. The information presented here is not specific to any individual's personal circumstances. To the extent that this material concerns tax matters, it is not intended or written to be used, and cannot be used, by a taxpayer for the purpose of avoiding penalties that may be imposed by law. Each taxpayer should seek independent advice from a tax professional based on his or her individual circumstances. These materials are provided for general information and educational purposes based upon publicly available information from sources believed to be reliableâ??we cannot assure the accuracy or completeness of these materials. The information in these materials may change at any time and without notice.
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