Saturday, November 11, 2017

Still without health insurance and not eligible for Medicaid? Chances are 4 in 10 you can get a free policy (with big deductible)

By Melissa Patrick
Kentucky Health News

Premiums are higher for health insurance through the Patient Protection and Affordable Care Act, but federal subsidies mean the total cost will be about the same. And many people will qualify for subsidies large enough to completely pay for a low-cost "bronze" plan -- or make it less than the penalty for not having health insurance.

To find an application assister or a sign-up event in
your county, go to
For now, the ACA is still the law of the land, despite repeated efforts this year to repeal and replace it, and that means everyone is required to have health insurance in 2018 or risk paying a tax penalty, with some very limited exceptions.

The 2018 penalty is $695 per adult and $347.50 per child, with a maximum of $2,085 per family or 2.5 percent of the household's income.

The Kaiser Family Foundation is encouraging the 10 percent of Americans who are still uninsured to make sure they know what it would cost to sign up for a health plan this year. The foundation says its recent analysis of plans for 2018 found that about four in 10 could be obtained at no cost.

The foundation found that "more than half of the 10.7 million people who are uninsured and eligible to purchase an Affordable Care Act marketplace plan in 2018 could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage."

It added, "Within that 5.8 million, about 4.5 million (42 percent of the total) could obtain a bronze-level plan at no cost in 2018, after taking income-related premium tax credits into account. "

According to Kaiser, 265,000 Kentuckians were uninsured in 2016. Of those, 114,000 were eligible for Medicaid. The other 151,000 could have bought a plan on, and about 77,000 of those would have been eligible for a tax subsidy to help pay for their coverage.

Among the 80,000 Kentuckians with policies on the exchange, about 80 percent will qualify for a tax credit or subsidy to reduce their monthly payments. Though premiums have gone up this year, most people's cost will be about the same because the credits are calculated to offset premium increases.

Many in this group will also qualify for the low- or no-cost bronze plans. so they are advised to compare all of their options before simply re-enrolling in the same plan or allowing the system to automatically re-enroll them.

Bronze plans are likely to have high deductibles and/or co-payments, so health experts stress the importance of looking at the whole plan, not just the premium cost.

In a recent webinar, the Kaiser foundation encouraged the remaining 20 percent of Kentuckians who don't qualify for any help and who will likely see the largest increases in their premiums to look at plans off the exchange, because they could be less expensive.

The foundation offers an easy-to-use individual mandate penalty calculator that lets you compare your penalty for going uninsured to the cost of coverage on the federal marketplace. It also estimates whether you would qualify for several, but not all, of the exemptions to the penalty.

To help with open enrollment, which ends Dec. 15, free application assisters are available in every county. They are also offering sign-up events throughout the state. To find an event in your county or an assister, go to The site also includes net payment examples for all regions of the state and 2018 sample scenarios for individuals and families. Help is also available through the state call center at 858 855-459-6328 and the customer center at 800-318-2596, which is available 24 hours a day, seven days a week.

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