Renee Reopell, a healthcare navigator, presented information about the Affordable Care Act at Community Board 6’s meeting last week. Kerry Goleski/The Forum Newsgroup
The New York online Health Benefit Exchange has been a point of confusion for many. Renee Reopell, a healthcare navigator, presented information about the Affordable Care Act and the exchange in New York at the Community Board 6 meeting in Kew Gardens last Wednesday. Her aim was to explain the system and how to sign up for health insurance through the website.
She stressed that the New York Health Benefit Exchange or marketplace is different than the federal website.
“Fortunately you do not have to sign up on the federal site,” she said.
If a person is already insured through their employer, that person does not need to use the New York Health Exchange, unless the benefits do not meet the minimum requirement.
Also, if a person uses Social Security, that individual should continue to use Social Security, rather than the NY Health Benefit Exchange.
For those who should use the NY Health Benefit Exchange, the enrollment period opened on Oct. 1, 2013 and will remain open until March 31, 2014. After that a person will receive a financial penalty.
“The online marketplace is a one-stop shop to see what subsidizes you are eligible for,” Reopell said.
A person can enroll in individual/family healthcare, Medicaid, Child Health Plus and the small business coverage.
In order to be a health plan offered on the website it must be a “qualified health plan,” meaning it must cover all essential health benefits assigned by the Affordable Care Act.
Plans that do not meet these standards can exist for another 11 months.
When choosing between each plan, there are four “metal levels” to choose from: bronze, silver, gold, and platinum. As premiums increase, out-of-pocket costs decrease.
“Platinum plan you play more each month, but your insurance company picks more of the bill,” Reopell said.
The decision between metal levels is up to the patron.
Applicants can choose which provider they will use and then the level.
Plans will be available for side-by-side comparison, where applicants can compare up to three plans at a time.
Financial assistance is in available in two forms. Advanced premium tax credit will reduce the cost of premiums for those earning less than 400 percent of the federal poverty level, which is $45,960 a year for an individual and $94,200 a year for a family of four. A tax credit may be used toward the premium, or individuals could receive a cash refund.
The cost-sharing reductions will lower co-payments and deductibles for those earning less than 250 percent of the federal poverty level for individuals – $28,725 a year for individuals and $ 58,875 a year for a family of four.
When applicants submit information about income on the website they can see which subsidies they will.
With the Affordable Care Act, they only look at your income, instead of other factors such as owning a car, owning a home, 401k, savings and more said Reopell.
There is a non-discrimination policy when it comes to charging. This means a plan cannot charge more based on a preexisting condition or a person’s sex, according to the marketplace website.
Prior to this, the argument was “women tend to use their health insurance more so they are being charged more. That is now illegal,” said Reopell.
Reopell also said, “You need a Social Security number to get insurance.” Those who are “undocumented are excluded from this.”
“Companies on the Marketplace can vary costs based on your age, where you live in the state, and your tobacco use,” according to WebMD.
For more information, go to https://nystateofhealth.ny.gov.
By Kerry Goleski
