by David Sayen, Regional Administrator - Medicare Arizona
Starting Oct. 1, Arizonans who lack health insurance, or who buy their own insurance, will have a whole new way to shop for coverage. It’s called the Health Insurance Marketplace, and you can learn more about it at www.Healthcare.gov.
Or you can call, toll-free, at 1-800-318-2596. Customer service representatives are available, in English and Spanish, 24 hours a day, seven days a week. One important thing to keep in mind is that you may be able to get lower costs on monthly premiums by buying health insurance through the Marketplace. This depends on your income and family size.
You’ll see the amount of savings you’re eligible for when you fill out your Marketplace application after Oct. 1, 2013. Prices shown for insurance plans will reflect the lower costs.
These lower costs are handled with a tax credit called the Advance Premium Tax Credit. The tax credit can be applied directly to your monthly premiums, so you get the lower costs immediately.
Until Oct. 1, you can get a rough estimate of costs and savings by using the Kaiser Family Foundation calculator. You can find the calculator at: http://kff.org/interactive/subsidy-calculator.
In general, if your income falls within the following ranges you’ll qualify to save money on your premiums in 2014. The lower your income within these ranges, the more you’ll save. (The amounts below are based on 2013 numbers and are likely to be slightly higher in 2014.)
• $11,490 to $45,960 for individuals;
• $15,510 to $62,040 for a family of 2;
• $19,530 to $78,120 for a family of 3;
• $23,550 to $94,200 for a family of 4;
• $27,570 to $110,280 for a family of 5;
• $31,590 to $126,360 for a family of 6;
• $35,610 to $142,440 for a family of 7;
• $39,630 to $158,520 for a family of 8
When you apply for lower costs in the Marketplace, you’ll need to estimate your household income for 2014.
Most people can use their household’s adjusted gross income for this estimate. If you know your 2013 adjusted gross income, use that and take into account any changes you expect in 2014.
Another way to estimate your income is to add up the following items for all the people in your household, based on what you think they’ll receive in 2014:
• Net income from any self-employment or business
• Unemployment compensation
• Social Security payments
Other kinds of income to include when estimating your 2014 income are: rental income, interest, dividends, capital gains, annuities, alimony, and some retirement and pensions.
When you fill out the Marketplace application, a number called “modified adjusted gross income” will be used.
Modified adjusted gross income is generally your household’s adjusted gross income plus any tax-exempt Social Security, interest, and foreign income you have. It’s used to determine your eligibility for lower costs on Marketplace coverage.
You don’t have to figure out this income yourself. The math will be done for you when you apply through the Marketplace.
When you apply, you’ll also learn if you’re eligible for savings on out-of-pocket costs such as deductibles, copayments and coinsurance. These are costs you have to pay when you get care.
These savings are based on your income and family size. For more details on out-of-pocket savings, go to www.Healthcare.gov.
By filling out a Marketplace application, you’ll also find out if you qualify for the Children’s Health Insurance Program and Arizona’s Medicaid program, also known as the Arizona Health Care Cost Containment System, or AHCCCS.
David Sayen is Medicare’s regional administrator for Arizona. The U.S. government agency that runs Medicare also will operate the Health Insurance Marketplace in Arizona.