Healthcare Questions Answered
Does Social Security count as income? Will my Medicare plan be impacted? How do I calculate my monthly premium? Will I be able to keep my doctor? Those were just some of the questions asked and answered Tuesday night in Meriden at the first of many “Healthy Chats” sponsored by Access Health CT, the state’s insurance exchange.
Most of the approximately 65 people who attended the conversation at the Meriden Public Library were aware of the exchanges and the Oct. 1 enrollment date, but they were looking for more information about how the new options apply to their own situations.
David James, of Meriden, said he had three children who are all almost over the age of 26 — the age at which children are no longer allowed to stay on their parents’ insurance.
He said he needs to know how affordable the plans will be for his children because if it’s too expensive they’re going to be coming to him for money.
There are low-priced catastrophic plans that cover the bare minimum of benefits for individuals under the age of 30, but those weren’t discussed Tuesday.
James also wanted to know what happens if the politicians in Washington decide to get rid of the Affordable Care Act.
Jason Madrak, chief marketing office for Access Health CT, said he doesn’t think “anyone here can read those tea leaves.” It ended up being the only question that went unanswered Tuesday.
Meriden resident Ruth Pedroso, who said she doesn’t have any health insurance, was excited about the opportunity even though she’s not so excited about having to pay for it.
“I don’t really have much of a choice,” Pedroso said.
Her sister, Astrid Ojedn, has insurance through her employer but she works for a company with a lot of part-time workers who will probably need to purchase their insurance on the exchange or pay the penalty.
“We don’t have to buy insurance for them but they have to get it, so I just wanted to hear the other side,” Ojedn said.
She said she thinks many of the younger workers will opt not to purchase the insurance and instead pay the penalty, which is $95 or 1 percent of your income, whichever is greater.
Lee Goodall, a community outreach worker with Access Health CT, said in that 2015 the penalty increases to $325 or 2 percent of income and in 2016 it’s $695 or 2.5 percent of income, whichever is greater.
One man wanted to know what happens if his income level changes over the period of a year. Madrak explained that since the income used to determine the government subsidy is based on what was reported to the IRS the previous year, that year’s monthly premium stays at that level for the entire year. But he acknowledged that the following year’s income could be different, which would then change the subsidy level or if a person brought in more money it could eliminate the subsidy entirely.
Madrak was peppered with questions from former House Speaker Chris Donovan, who lives in Meriden and has kept a low profile since losing his Congressional campaign.
“If your employer offers a more expensive health care plan, can you opt out and get a cheaper plan through here?” Donovan asked.
Madrak said there is something called a “hardship waiver” that an individual can apply for in order to get their insurance through the exchange if their employer’s plan exceeds 9.5 percent of the family’s income.
Donovan also asked if there were subsidies for small businesses. Madrak explained that any small business can receive a tax credit of up to 50 percent of what they contribute to their employees’ insurance when they purchase it through the exchange.
Also, individuals who make less than 138 percent of the federal poverty level will qualify for Medicaid and families with children and incomes below 185 percent of the federal poverty level will still qualify for Husky, which is what the state calls its Medicaid program. The name for the Husky program won’t change.
“If a person qualifies for Medicaid or Husky, do they have to wait to enroll?” Donovan asked.
“That’s a great question,” Madrak said. “Medicaid enrollment is ongoing so if you actually qualify for Medicaid insurance on Oct. 1 then you can receive coverage benefits well before Jan. 1.” Everyone else will have to wait for their coverage to start on Jan. 1, 2014.
For more information about how to calculate your monthly premium click here. Also, to see what benefits are covered under the three different insurance levels and what the various out-of-pocket costs will be, click here.
There are four more conversations scheduled to take place in Waterbury on Aug. 20, New Britain on Aug. 22, Bridgeport on Sept. 4, and Hartford on Sept. 7. For more information about where each meeting will occur visit http://www.accesshealthct.com/news-events/events/