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The new health insurance marketplace and you

What to expect

If you have insurance through an employer: You can keep your employer-sponsored coverage. If your employer discontinues coverage or if you can't afford it, you may find a health plan on the exchange.

If you are uninsured: You will be able to access health coverage via the new health insurance exchange in your state. Check with a financial counselor at Hennepin, 612-873-2767 for more information.

If you are a young adult: All health plans that provide dependent coverage of children are required to extend coverage to children up to age 26, regardless of the child's marital status, financial dependency, residency, student status and employment status.

Health care reform under the Affordable Care Act (ACA) is moving full speed ahead with a number of changes on the way in 2014. Some of the important highlights for individuals and families include:

Everyone must have health insurance. This “individual mandate” requires everyone (with few exceptions) to have health insurance or pay a penalty. If you don't have health insurance through an employer, you can buy your own (individual or family) policy or enroll in a free or low-cost health plan, depending on your income.

Guaranteed access to health insurance means that you can get health coverage regardless of your health status or pre-existing conditions. Health insurance companies can't turn you away or drop your policy due to a current or past illness, injury or other health condition.

Health insurance exchanges provide a new way to shop for and enroll in health plans. Each state will have its own exchange open for enrollment in October 2013 with coverage effective in January 2014. Some states have chosen to implement state-run health exchanges, while others have opted for a federally facilitated exchange or partnership exchange with the federal government.

Health plans on the exchange offered by multiple insurance companies make it easy to shop and compare plans. You can review which medical providers participate in various health plans and choose the best fit for you and your family. Health plans are classified as bronze, silver, gold and platinum based on the percentage of costs covered (premiums are lowest in a bronze plan, highest in a platinum plan). These plans include a basic package of benefits including essential health benefits and preventive care, and they follow established limits for out-of-pocket costs (i.e., deductibles, copays and out-of-pocket maximums).

Premium subsidies may help make health insurance more affordable. Premium tax credits based on income offset the cost of premiums for those with income below 400 percent of Federal Poverty Level (FPL). Those who meet this income guideline may get a tax credit that can be applied to a health plan sold on the exchange. Use this tool to walk through FPL as it relates to your income and family size: kff.org/interactive/subsidy-calculator

Medicaid expansion (in participating states) expands Medicaid health coverage to more low- to moderate-income Americans. Individuals and families can go to the exchange to find out if they are eligible for Medicaid and/or the Children's Health Insurance Program (CHIP) and enroll in these government programs.

Navigators and other in-person assistors trained and certified by the state and/or federal government are available to give one-on-one enrollment assistance.

We Can Help

To get started, go to www.mnsure.org or call 1 855-3MNSURE (1-855-366-7837).

There are also public computers available in the Hennepin County Medical Center cafeteria (Orange building, Level 3).

You can speak directly with a Hennepin financial counselor by calling 612-873-2767 or visit with one at the following locations:

  • Green Building, Level 9
  • Purple Building, Level 1 (P1.645), next to Interpreter Services
  • Blue Building, Level 1 (B1.114), in the Disability Evaluation Center
  • Red Building, Level 1 (R1.063), in the Emergency Department
  • Red Building, Level 5, OB/GYN Clinic front desk
  • Red Building, Level 7, ENT, Eye and Pediatric Clinic
  • Whittier Clinic, East Lake Clinic, Richfield Clinic, Brooklyn Park Clinic
 
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