It's Your Right To Know Your Healthcare Options

The Health Insurance Marketplace Open Enrollment starts Oct. 1

September 20, 2013 | 2 min reading time
Marketplace-Healthcare
The Affordable Care Act has been law for over two years and has already benefited millions of Americans. Seniors can access preventive care with no co-pays or deductibles, 17 million children can no longer be denied coverage for pre-existing conditions, individuals cannot be charged more or have their coverage cancelled when they become sick, women cannot be charged higher premiums because they are women, children can stay on their parents insurance plans until age 26, and insurance companies cannot earn more than 20% in profits.

On Oct 1 an important component of the law, The Health Insurance Marketplace, will make insurance affordable for the 15% of the population in the St. Louis region that do not currently have health insurance (170,000 people). Mayor Slay has instructed Health Director, Pam Walker and her staff to organize enrollment sessions beginning Oct. 1 through Dec. 31, 2013 because you have a right to know what your health care choices are. We are here to educate, inform and assist you with enrollment. Locations and times will be announced by Oct 1.

Some important things for you to know about the Marketplace include: 
  1. You can find out more right now about what your options might be at www.healthcare.gov or www.covermissouri.org
  2. You can talk to someone at 1-800-318-2569 (TTY 1-855-889-4325) if you are an individual. Small business owners can talk to someone at 1-800-706-7893 (TTY 1-800-706-7915)
  3. Enrollment begins Oct 1, 2013 and goes through March 31, 2014. Coverage begins Jan. 1, 2014.
  4. The Marketplace is not for you if you are a senior on Medicare, are on Medicaid or get health insurance through your employer. So tell your uninsured friends and family about this new benefit but do not worry about changes in your own coverage.
  5. There is no cost to explore your options and sign up for the Marketplace. 
  6. Do not let anyone tell you what your options are, find out for yourself. 
  7. Do not share your information with anyone calling you over the phone offering to sign you up for a fee or saying they are with the government and you are breaking the law if you do not sign up. These are scams. 
  8. In the St. Louis region all of the Community Health Clinics, hospitals, and many community based organizations have staff trained to help you enroll. Go to someone you trust for information and assistance. 
  9. Families with incomes up to $94,200 qualify for tax subsidies to help lower their costs. 
  10. Premiums cannot “skyrocket” as some have claimed because insurance companies cannot make more than a 20% profit. 

Here’s an example of how it will work, say your 32 year old son currently pays an annual premium of $2148 for catastrophic coverage only. He pays high co-pays and deductibles. His out of pocket costs are $5000. If he gets sick, during a time when he would need coverage the most, he can be cancelled or have his rates increased.

Now look at this, according to the Kaiser Family Foundation Calculator on www.healthcare.gov his yearly premium in the Health Insurance Marketplace will be just $300, he will qualify for a tax credit of $2715 which would cover his out of pocket costs of not more than $2250. His plan will include primary care, mental health care and pharmacy not currently in his expensive catastrophic plan. He cannot be cancelled or charged higher premiums if he becomes sick.

He will have comprehensive health care coverage for $6983 less than he pays now for just catastrophic coverage!

So don’t believe the negative political hype about the Affordable Care Act, find out for yourself. It’s your right to know you options and it’s your right to have affordable health insurance coverage.
  • Department:
    Department of Health
  • Topic:
    Health

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