affordable care act new protections & coverage options for consumers nj for health care/nj...
TRANSCRIPT
Affordable
Care Act
New Protections & Coverage Options for
Consumers
NJ For Health Care/NJ Citizen Action
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The Law Increases Your Access to Affordable Care
In many cases, you can get preventive services for free:
New Health Insurance OptionsWhat these changes mean for NJ
MEDICAID EXPANSION
Income limits are expanded
More people will qualify for
NJ FAMILY CARE
You can be working and still qualify
Individuals who earn up to $15,856Family of 4 earning up to $32,499 can qualify
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Not eligible for Medicaid?
SHOP the
HEALTH INSURANCE MARKETPLACE
- Apply for coverage
- Apply for subsidies to help reduce
the cost of premiums
Who qualifies for subsidies?
Individuals up to $45,960
Family of four up to $94,200
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WHO WILL QUALIFY?
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Number in Household Income Range to Qualify for Lower Cost
1 $11,490 to $45,960
2 $15,510 to $62,040
3 $19,530 to $78,120
4 $23,550 to $94,200
5 $27,570 to $110,280
6 $31,590 to $126,360
7 $35,610 to $142,440
8 $39,630 to $158,520
You can purchase on the Marketplace if….
You are an individual, family or small business not eligible for coverage
through someone or someplace else (like an employer)
You are a citizen or legal immigrant
Everyone enrolling in the exchange must verify legal status
You are a member of Congress:
The ACA requires them to use the Exchange
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Four Levels of Coverage
Catastrophic Coverage Option
AN ALTERNATIVE OPTION FOR:
• Young adults to age 30 • Or those with hardship exemption
• Unable to purchase coverage that is < 8% of income
Plans offer: • Limited coverage at low cost with high deductibles
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What will coverage cost?
If you qualify for a subsidy….
Your premium contribution
will be less than 10%
of your annual adjusted gross income
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Two ways to help reduce cost for those who qualify
Premium Tax Credits
• What is it: A tax credit based on your reported income
• How does it work? Credit is applied to the cost of the premium up front
• How much will it be? If you qualify for a tax credit, you premium will be between 2% and 9.5% of your yearly income
Cost Sharing Reductions
• What is it: Another layer of assistance for those who earn less will qualify for reduced co-pays and deductibles
• Who qualifies? Individuals with income less than 250% of federal poverty level
$28,725 for individuals; $58,875 for family of 4
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How will consumers enroll?
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Apply On-Line
If you qualify for Medicaid Expansion:
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Apply by Phone
National toll-free hotline
1-800-318-2596
If you qualify for Medicaid Expansion:
NJFamilyCare
1-800-701-0710
In-Person Enrollment AssistanceNJ Navigators
• Food Bank of Monmouth/Ocean Counties• 732-918-2600
• Center for Family Services (NJ Southern Counties)• 1-877-9-ACCESS (1-877-922-2377)• [email protected]
• Oranges Navigator Project: (Essex) 973-500-6031• Urban League of Hudson/Bergen County
• 201-451-8888 • Public Health Solutions (Hudson & Essex)
• 646-619-6539 • [email protected]
NJ For Health Care/NJ Citizen Action
Certified Application Counselors• Available at:
• Federally Qualified Health Centers• Libraries• Community Health Centers• Hospitals• Community service organizations• Some local retailers & drug stores
• Find the closest Assistor at:
https://localhelp.healthcare.gov/
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Resources
NJ For Health Care/NJ Citizen Action
NJFAMILYCARE.ORG1-800-701-0710
National Hotline800-318-2596
REMEMBER…..
INITIAL OPEN ENROLLMENT FOR ALL PLANS
October 1, 2013 – March 31, 2014
After March 31Enrollment will be open
Only to those who qualify for NJ FAMILY CARE
or who have a change in circumstance
Next Annual Open Enrollment
October 15 – December 7
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Contact Us
NJ For Health Care/NJ Citizen Action
Consumer Health Helpline: 1-888-NJ GET WELL (888-654-3893)
Maura CollinsgruNJCA Health Policy Advocate732-246-4772 [email protected] Facebook.com/NJforHealthcare