I wanted to give you a brief run down of what we know about the new health care plans for individuals & family plans – meaning, anyone that does not get insurance through their employer.
To begin with all new plans must cover essential health benefits such as doctor visits, hospitalization, emergency care, maternity, pediatric care for your kids, prescriptions, etc. Starting in 2014 insurance plans will be very easy to compare. There will be four basic levels of coverage: platinum, gold, silver, and bronze. The system is designed to allow the consumer to compare plans in the same category or across categories. As coverage increases, so does the monthly premium.
There are three financial assistance programs that consumers will have access to. I have taken the following information directly from the Covered California website to describe these:
2. Cost-sharing subsidies: Cost-sharing subsidies reduce the amount of health care expenses an individual or family has to pay when you get care. These expenses might include copayments or other costs incurred when you receive medical care.
An individual making less than $15,415*
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Medi-Cal, a free government program
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An individual making $15,415 to
$27,935*
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You qualify for help in paying out-of-pocket costs like deductibles and co-pays. You also qualify for a tax credit that will lower the amount of your monthly premium.**
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An individual making $27,936 to
$44,680*
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You qualify for a tax credit that will lower the amount of your monthly premium.**
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An individual making over
$44,680*
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You do not qualify for government assistance but you are still eligible to buy health insurance through Covered California.
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A family of four making
less than $31,810*
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Medi-Cal, a free government program
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A family of four making
$31,810 to $57,635*
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You qualify for help in paying out-of-pocket costs like deductibles and co-pays. You also qualify for a tax credit that will lower the amount of your monthly premium.**
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A family of four making
$57,636 to $92,200*
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You qualify for a tax credit that will lower the amount of your monthly premium.**
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A family of four making
over $92,200*
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You do not qualify for government assistance but you are still eligible to buy health insurance through Covered California.
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** You must enroll through Covered California to be eligible for your tax credit