We are about 100 days away from the expected opening of a federally managed health insurance exchange (now referred to as the marketplace). There are still many hurdles to overcome, not the least of which is the backbone (data hub) that is supposed to shuttle your information back and forth between half a dozen or so federal agencies plus the Georgia DCH (Medicaid) and probably a few other agencies I am overlooking.
The data hub has not been completed and it not expected to be finished until August leaving only a few weeks to test for bugs.
If you think you qualify for a subsidy the place to start is the exchange/marketplace. The application process is expected to take about 45 minutes and you will need to provide financial information such as your income tax filing status, last years wages, projected wages for 2014 and other personal information.
Once approved for a subsidy you will then be directed to a list of health insurance carrier plans and rates. The subsidy amount will vary depending on your income (if less than 400% of the Federal Poverty Level) and your share of the premium you will be expected to pay will range from the lesser of the net premium (after subsidy) or a percent of your income.
Lower income families will pay up to 2% of their MAGI (Modified Adjusted Gross Income) while higher income families will pay up to 9.5% of MAGI.
A single person in Georgia will exceed the subsidy income bracket at $45,960 while a family of 4 can earn up to $94,200 and still qualify for a subsidy.
Only 6 carriers have indicated they will offer plans on the exchange and only one (Blue Cross) will have plans statewide. Other carriers will only offer plans in select counties or zip codes.
Exchange plan choices will be limited. The least expensive "Bronze" plans will come with a $6,000 deductible. Silver plans have a $2,000 deductible and I do not expect to see any Gold plans ($750 deductible) on the exchange.
In most cases networks will be much smaller than you are accustomed to, especially on the lower priced Bronze plans. Also expect Rx formulary's to be limited and higher than current copay's.
You are not required to buy on the exchange, only if you want or need a subsidy.
Plans sold off the exchange will offer richer benefits, broader networks and expanded Rx formulary's.
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