What to know about La.’s new insurance marketplace
BATON ROUGE (AP) — A six-month enrollment period starts Tuesday for insurance coverage through the new health insurance marketplaces that were created by the federal Affordable Care Act. A look at who’s eligible and what’s available in Louisiana’s marketplace, run by the federal government:
WHO CAN SIGN UP?
If you don’t have insurance or you currently buy your own policy, the marketplace is for you to shop for health care coverage. If you have Medicare, Medicaid or insurance through your job, the marketplace isn’t for you.
Enrollment runs from Oct. 1 through March 31 for 2014 coverage plans.
WHERE CAN YOU FIND INFORMATION?
The marketplace is online at www.healthcare.gov , or you can call 1-800-318-2596 to speak with someone who can help you sign up.
The Kaiser Family Foundation has a calculator that provides ZIP code-specific estimates of the insurance premiums and tax subsidies available for people who buy coverage through the marketplace at: kff.org/interactive/subsidy-calculator/ .
The Louisiana Department of Insurance has information about how to enroll in a health insurance plan at http://www.ldi.state.la.us/Health/index.html , and its staff can answer questions about the marketplace at 1-800-259-5300.
WHO’S OFFERING COVERAGE?
Blue Cross and Blue Shield of Louisiana is offering health plans through the marketplace in every parish.
The Louisiana Health Cooperative also will offer coverage statewide, but the new nonprofit is still working to get its plans up and running.
Vantage Health Plan will offer plans on the marketplace in many Louisiana parishes.
Humana will offer insurance on the marketplace only in Jefferson Parish.
WHAT’S THE COST OF AN INSURANCE PLAN?
Different plans are available, under categories of bronze, silver, gold and platinum. The bronze plans have the cheapest premium costs per month, but you’ll have to pay more out-of-pocket as a cost share for services.
For example, a 27-year-old in Louisiana who makes $25,000 a year will pay $71 a month on average for the lowest cost bronze plan or $145 a month for one of the silver plans, after federal subsidies are applied, according to the U.S. Department of Health and Human Services.
A family of four with an annual income of $50,000 will pay $15 per month on average for the lowest cost bronze plan or $282 a month for one of the silver plans, after the subsidy, according to HHS.
WHAT ABOUT THOSE FEDERAL SUBSIDIES?
More than 353,000 Louisiana residents are estimated to be eligible for federal financial subsidies in the form of tax credits to help pay for insurance coverage through the marketplace. Sliding-scale tax credits are available to households earning between 100 percent and 400 percent of the federal poverty line, or $11,490 to $45,960 for an individual or $23,550 to $94,200 for a family of four.
AND IF I DON’T GET INSURANCE?
Beginning in 2014, most people will have to have health insurance or pay an annual penalty to the federal government. The fine for the first year is $95 per adult and $47.50 per child (up to $285 per family), or 1 percent of your income, whatever is higher. The fines grow larger in later years.
WHO’S LEFT OUT?
Thousands of Louisiana residents below the poverty line don’t qualify for subsidies to buy coverage because they were expected to get Medicaid though an expansion of the free health care program for the poor. Gov. Bobby Jindal refused the Medicaid expansion, so those residents are expected to remain uninsured. They don’t face penalties for not having insurance.