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Health Insurance for Low Income Families

The Right Coverage at the Lowest Price

Your search for affordable Health, Medicare and Life insurance starts here.

Call us 24/7 at (800) 658-0912 or Find an Agent near you.

When looking for health insurance for low-income families, you may be surprised to find that you have more options than you think. With the passing of the Affordable Care Act (ACA), all families are required to purchase insurance or pay a steep fine, but for low-income families, the expansion of programs was designed to cater to the needs of those with limited incomes.

No matter your income level, HealthMarkets Insurance Agency can help you find an affordable health insurance to help you avoid paying the Individual Mandate. Our licensed agents are available to understand your unique medical needs and financial constraints to pair you with the right plan. With our network of over 180 insurance providers nationwide, we’re confident we can find your family coverage.

Low-Income Families Have Health Care Options

Under the ACA, not only are health plans more affordable than prior to these laws, but families making a modest income can be eligible for subsidies to make the cost of health care better fit their price range.

Introduction of Metal Levels

Now when you purchase a health plan, you can choose the level of coverage, or “metal level,” that works for your medical and financial needs. The amount of coverage you receive from your health insurance provider can be dependent on how much you pay for monthly premiums.

In general, there are four types of plans:

  1. Bronze: 60% covered by your health insurance provider, 40% covered by you.
  2. Silver: 70% covered by your health insurance provider, 30% covered by you.
  3. Gold: 80% covered by your health insurance provider, 20% covered by you.
  4. Platinum: 90% covered by your health insurance provider, 10% covered by you.

Ten Essential Health Benefits

No matter which plan you purchase or how much you pay for it, the ACA guarantees 10 essential health benefits to those covered under health insurance. These benefits are considered necessary services to maintain good overall health, and are required to be covered when you receive care from an in-network provider.

These ten benefits include:

  1. Prescription drugs
  2. Pediatric services
  3. Preventive and wellness services, and chronic disease management
  4. Emergency services
  5. Hospitalization
  6. Mental health and addiction services
  7. Pregnancy, maternity, and newborn care
  8. Ambulatory patient services
  9. Laboratory services
  10. Rehabilitative and habilitative services and devices

Tax Credit and Reduction Subsidies

Specific to families making a low income, the ACA also introduced a subsidy program to help families make health care more affordable to them. There are two subsidies you may qualify for:

  1. Premium Tax Credit: Families making between 100% and 400% of the Federal Poverty Line can get some or all of their monthly premium covered by either direct payments from the government to your health insurance provider, or by filing a tax return at the end of the year.
  2. Cost-Sharing Reduction: Families making between 100% and 250% of the Federal Poverty Line can get some of all of their out-of-pocket costs (e.g. coinsurance, copayments, deductibles) covered by requiring your health insurance provider to cover a larger percentage of costs than your metal level indicates.

How Can Low-Income Families Find Health Coverage?

It’s easy to find health insurance for low-income families when you talk to one of the knowledgeable, licensed agents at HealthMarkets. We offer free, no-obligation quotes for families looking for insurance the fits their budget and health needs.

To learn of your eligibility or about how affordable your health insurance can be, give us a call at (800) 360-1402 or request a free quote online today.

Affordable Health Insurance For Low Income Individuals and Families

The Right Coverage at the Lowest Price

Your search for affordable Health, Medicare and Life insurance starts here.

Call us 24/7 at (800) 360-1402 or Find an Agent near you.

Since the passing of the Affordable Care Act (also known as Obamacare or the ACA), finding affordable health insurance for low-income families has become more accessible than before. With subsidy programs in place to help families making a modest income, comprehensive health care can be a reality for all Americans.

At HealthMarkets Insurance Agency, we work with families across the nation to find health insurance that works comfortably with their unique budget and health needs. Our licensed agents are familiar with subsidy programs that can help families make health care more affordable. Contact us today to see what we can do for your family.

Get Low-Cost Health Care with Subsidies

When the ACA passed as law, new health insurance subsidies were introduced to help families making at or below the Federal Poverty Line (FPL) afford health care. If your family makes a combined annual income of the FPL, there are two types of subsidies your family may qualify for:

The Premium Tax Credit is a type of subsidy that allows you to help pay for or totally cover your monthly premiums. This applies to families who enroll in any of the four metal levels of coverage: Bronze, Silver, Gold, or Platinum.

With this subsidy, you can choose whether to have your premium paid directly to your health insurance provider from the government, or you can claim this credit on your annual tax return.

To be eligible for this tax credit, you must:

  1. Have a combined annual household income between 100% and 400% of the FPL.
  2. Not be eligible for Medicare, Medicaid, CHIP, or TRICARE.
  3. Not be able to get coverage through your employer’s plan.
  4. Not be claimed as a dependent by another person.

The Cost-Sharing Reduction helps lower or even cover the amount you pay out of pocket when you receive health care. This means that when you go to the doctor’s office, get an x-ray, or visit the emergency room, you can have your out-of-pocket expenses (e.g. deductibles, copay, coinsurance) lowered by having your health insurance provider cover more of your costs.

To be eligible for this subsidy, you must:

  1. Have a combined annual household income between 100% and 250% of the FPL.
  2. Have at least a Silver plan.

Help From HealthMarkets Insurance Agency

Even with healthcare reform in full swing, finding insurance that fits your medical needs and your budge can require careful consideration, especially if you’re unsure of what programs are available to you. HealthMarkets can help you sort through policies to find the right one for you.

We offer a free service to help people with unique medical and financial needs to find the coverage that they’re looking for. When you contact us, we’ll quickly compare what you can afford to the policies of more than 180 insurance provider nationwide to find affordable health insurance for low-income families.

The service is quick and easy, so call us at (800) 360-1402 or request a free quote online today.

Forbes: http://www.forbes.com/sites/investopedia/2013/10/01/how-to-choose-between-bronze-silver-gold-and-platinum-health-insurance-plans/
IRS: https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Questions-and-Answers-on-the-Premium-Tax-Credit
KFF: http://kff.org/health-reform/issue-brief/explaining-health-care-reform-questions-about-health/

The Right Coverage at the Lowest Price

Your search for affordable Health, Medicare and Life insurance starts here.

Call us 24/7 at (800) 827-9990 or Find an Agent near you.

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The Right Coverage at the Lowest Price

Your search for affordable Health, Medicare and Life insurance starts here.

Call us 24/7 at (800) 827-9990 or Find an Agent near you.

© 2018 HealthMarkets Insurance Agency. All rights reserved.

Attention: This website is operated by HealthMarkets Insurance Agency and is not the Health Insurance Marketplace website. In offering this website, HealthMarkets Insurance Agency is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans being offered in your state through the Health Insurance Marketplace website. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at HealthCare.gov.

HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in a health plan. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled.

UnitedHealthOne sm is a brand representing the portfolio of insurance products offered to individuals and families through the UnitedHealthcare family of companies. Golden Rule Insurance Company or UnitedHealthcare Life Insurance Company is the underwriter and administrator of these plans.

Sources:
Kaiser Family Foundation (2013). Average Single Premium per Enrolled Employee For Employer-Based Health Insurance. | HealthMarkets. Telephone survey to assess the satisfaction of customers and prospects in a survey population of 5745 participants. April 9-15 of 2014.

How to Find Low-Cost Health Insurance: FAQ

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If you’re having trouble finding health insurance you can afford, you’ll find more options now because of the Affordable Care Act.

Here are some common questions people have about finding low-cost health insurance.

I’m a 23-year-old college grad, and I’d like to get back on my parents’ health coverage until I find a job with benefits. How do I do this?

To get started, contact your parents’ insurance company to make sure it offers coverage for dependents. If it does, then the insurance plan has to accept you until you’re 26. You’re eligible even if you live away from home or you’re married.

Next, find out when you can enroll. You may have to wait for the open enrollment period (generally November to January).

Keep in mind that going on your parents’ insurance won’t be free. If the plan only covers your parent — or a parent and spouse — expect the monthly insurance cost to go up when you join.

I buy my own insurance and have trouble paying for it. Will it be more affordable now?

It may be. You may be able to get tax credits to lower your premiums and other costs of health insurance. To be eligible, you must:

  • Be a citizen or legal resident
  • Buy your coverage through your state’s new health insurance Marketplace, also called an Exchange
  • Make about $11,880 to $47,520 a year if you are single or $24,300 to $97,200 a year if you are in a family of four

If you make less than about $16,400 if you are single, or less than about $33,500 as a family of four, you may be eligible for Medicaid. Medicaid will cost you less than a plan on the Marketplace.

Unfortunately, not all states are expanding Medicaid. If that’s the case and your income is less than $11,880, you may not be able to enroll in Medicaid or be able to get a tax credit.

In general, you’re not eligible for the tax credits if you could get coverage through a workplace. However, the coverage offered by your employer must be considered affordable. If your company offers a plan that costs more than 9.66% of your income or that does not cover at least 60% of the cost of covered benefits, you can look for a more affordable plan through your state’s Marketplace and may receive tax credits to lower your costs.

How do I find out if I’m eligible for a tax credit? If I am, how do I get it? I need the money now. I can’t wait to get reimbursed.

When you go to your state’s Marketplace, you’ll fill out an application that includes details about your income and family size. Based on these, you will find out how much of a tax credit you qualify for. Once you pick the plan you want, you’ll be able to see exactly how much money it will cost you.

One way the tax credits can work is that the government sends the money directly to the health plan you are joining. The plan uses that money to lower the amount you have to pay in premiums for the year. So each month, your premium cost is less than it would have been without the tax credit.

I’ve tried to get on Medicaid in the past but couldn’t. Will my chances be better under the Affordable Care Act?

Possibly, but a lot depends on what state you live in.

Health reform called for more people to be able to get Medicaid. However, it’s up to each state to decide whether to expand the program.

To find out if you can get on Medicaid now, go to HealthCare.gov. If the federal government is running the Marketplace in your state, you can fill out an application there. If your state is running its own Marketplace, you will be directed to another website where you can fill out an application. You can fill out one application to see if you qualify for Medicaid or for a tax credit to buy insurance on the Marketplace.

What’s the cheapest insurance I can get through the Marketplace?

If you define cheap as the least amount to pay every month — the lowest premium — just for having insurance, then you may want to check out a “catastrophic” plan. This type of plan often has low premiums. It covers 3 office visits a year and will also provide free preventive health services. After that, you must meet your deductible before your insurance will provide any coverage.

Often, though, when a plan has a low premium, the deductible is higher. That’s true for catastrophic plans. A deductible is the amount you have to pay for medical bills before your insurance plan starts to pay.

A catastrophic plan isn’t for everyone. To get on this type of plan, you must be under 30 or unable to afford other coverage.

A high-deductible health plan (HDHP) is another choice for paying less each month.

If you need to get health care often, it might be cheaper for you to pay more each month so that you have a lower deductible. That means your health plan will start contributing to the cost of your care faster.

I have a high-deductible health insurance plan that leaves me on the hook for a lot of medical expense each year. Can I do anything to save money on my health care?

Consider starting a health savings account known as an HSA. An HSA is a type of investment account paired with a high-deductible health plan that allows you to pay for medical bills with money you’ve set aside tax free.

The money that you put into an HSA is not considered part of your income.

If you’re self-employed you can make tax-deductible contributions to your HSA.

You don’t have to pay taxes when you use the money either, as long as you’re using it to pay for qualified health expenses. The money you deposit into the account rolls over from year to year and continues to grow tax free over time. You can use the money at any time to cover the cost of medical expenses.

Can I just go without insurance and get my care from the ER?

Counting on the ER for health care is not a good substitute for seeing your own doctor on a regular basis. The hospital is also likely to send you a bill for your treatment, even if you’re uninsured.

You can go without health insurance. However, if you do, you’ll pay a penalty of $95 per adult and $47.50 per child in 2014 or 1% of your annual income, whichever is greater. The penalty will go up steeply in the coming years.

Certain people may be exempt from having to pay the penalty.

I’m about to turn 65, and I’m realizing that even with Medicare, my health care costs are going to be hard to afford. Can I get any help?

Maybe. It depends on how much you make each year. How much money you have in bank accounts and stocks is also considered. If your income is below a certain level, you may be eligible for one or more Medicare Savings plans in your state.

There are several types of savings programs. One helps pay premiums for Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).

There are also savings plans to help pay deductibles, coinsurance, and copays.

American Public Health Association: “Why do we need the Affordable Care Act?” and “Medicaid expansion.”

HealthCare.gov, “Young adult coverage;” “Medicaid;” “Health savings account (HSA);” “Flexible spending account (FSA);” “Tax Credits in 2014;” “Co-insurance;” and “Co-payment.”

U.S. Department of Labor: “Young adults and the Affordable Care Act: Protecting young adults and eliminating burdens on families and businesses.”

Families USA: “The young person’s guide to health insurance for graduating seniors.”

Henry J. Kaiser Foundation: “Explaining health care reform: Questions about health insurance subsidies” and “The requirement to buy coverage under the Affordable Care Act beginning in 2014.”

U.S. Department of Health and Human Services: “2013 poverty guidelines” and “Health care law protects consumers against worst insurance practices.”

Health Insurance 101: “Federal Subsides: Helping People Afford Health Care;” “Standardizing Health Plans;” and “What are high-deductible plans paired with a savings account?”

Caldwell, N. PLoS One, Feb. 27, 2013; vol 8.

Florida health insurance

Florida residents have until December 31, 2017 to enroll in coverage for 2018, due to hurricane-related extension

  • Louise Norris
  • Individual health insurance and health reform authority; broker
  • December 27, 2017

Florida 2018 enrollment update

Florida insurance overview

Open enrollment for 2018 coverage ended on December 15, 2017 in Florida, but there’s a special enrollment period for Florida residents due to the hurricanes that hit the state in 2017. People in Florida, as well as those who lived there during the hurricanes, have until December 31 to enroll in a plan through the exchange, with coverage effective January 1, 2018.

Florida has one of the highest uninsured rates in the country (12.5 percent in 2016, as opposed to 8.6 percent for the US as a whole), but it also leads the US in terms of the number of people who sign up for health insurance in the state’s exchange. Nationwide, only a small fraction of the population has coverage in the individual health insurance market — most people get their coverage from employer-sponsored plans or government-sponsored plans. But the percentage of people in Florida with individual market coverage is nearly double the national average, which helps explain why Florida has such high enrollment numbers in the exchange.

For 2017 coverage, 1,760,025 Florida residents enrolled (the second-ranked state was California, with 1,556,676 enrollees). And for 2018, Florida had 1,715,227 enrollees during open enrollment, again coming in far above the rest of the country in terms of enrollments (and nearly reaching 2017’s enrollment total, despite the fact that open enrollment was half as long for 2018). The second-ranked state for 2018 enrollments was again California, with 1,420,000 enrollees as of mid-December — but with the caveat that open enrollment continues until the end of January in California, whereas it ended on December 15 in Florida (with additional enrollments possible through December 31 due to the hurricane-related special enrollment period).

In 2016, Florida lawmakers passed House Bill 221, which bans the practice of balance billing. Florida has been heralded as one of the more progressive states on this issue, as there is no solid federal policy in terms of balance billing.

Florida health ratings

When it comes to public health, various ratings place Florida in the bottom half of the nation. United Health Foundation’s America’s Health Rankings is one of them. In the 2017 edition, Florida ranks 32rd — but that’s up four spots from the previous edition, tied with Utah for the most improved state. From 2016 to 2017, Florida saw a decrease in the percentage of children living in poverty and suffering from frequent mental distress, both of which contributed to the state’s improvement in the overall rankings.

But the 2017 edition of America’s Health Rankings places Florida 46th in terms of the percentage of the population that has health insurance. Despite Florida’s huge enrollment numbers in individual market coverage, the state has refused to accept Federal funding to expand Medicaid under the ACA. As a result, there are an estimated 384,000 Florida residents in the coverage gap — ineligible for Medicaid and also ineligible for premium subsidies, essentially without any realistic options for health insurance coverage.

The 2017 Scorecard on State Health System Performance ranked Florida 39th, the same as it had been in the previous edition of the Scorecard. The Scorecard evaluates a range of health indicators and gives an overall score to each of the 50 states and the District of Columbia. Florida’s scorecard details how the state scored on individual measures within five categories: Access, Prevention & Treatment, Avoidable Hospital Use & Cost, Healthy Lives, and Equity. The state earned its lowest marks for Avoidable Hospital Use & Cost, coming in 45th. But Florida was in the second quintile (20th place) in the Healthy Lives metric.

While it does not include an overall score, the 2016 edition of Trust for America’s Health provides a wealth of public health information; see Key Health Data About Florida. As it does in other rankings, Florida’s percentage of uninsured residents stands out as an area needing much improvement. Based on 2014 data, Trust for America’s Health reports that 16.6 percent of Floridians – adults and children – were uninsured.

Some Florida counties fared far worse than the 16.6 percent average. County-by-county health rankings from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin showed a range of 15 to 33 percent uninsured across the state.

Is Obamacare helping Florida’s uninsured?

Although the Sunshine State has not embraced Obamacare from a legislative standpoint, the healthcare reform law has had some positive impacts there.

Florida’s federally facilitated health insurance exchange has the nation’s largest number of eligible of enrollees and highest enrollment numbers, and according to US Census data, Florida’s uninsured rate was 20 percent in 2013, and had dropped to 12.5 percent by 2016.

The national average uninsured rate was down to 8.6 percent by 2016, but Florida’s rejection of federal funding to expand Medicaid has locked a significant portion of the population out of coverage. If Florida were to expand Medicaid, the uninsured rate would drop substantially.

2018 Obamacare rates and carriers

Six insurers are offering plans in Florida’s exchange for 2018, with the following average approved rate increases (silver plans rate increases are the largest, because the cost of cost-sharing reductions has been added to silver plan rates for 2018):

  • Florida Blue (BCBS of Florida): 38.1 percent
  • Florida Blue HMO (Health Options): 36 percent
  • Florida Health Care Plan Inc. (a Florida Blue subsidiary): 26.5 percent
  • Ambetter (Celtic): 46.1 percent
  • Molina: 71.2 percent
  • Health First Health Plans: 39.3 percent

Humana exited Florida’s individual market at the end of 2017, but Celtic/Ambetter has expanded to cover 22 counties in 2018, and Health First expanded from four counties to five.

Although rate increases are significant for 2018, premium subsidies are much larger, resulting in after-subsidy rates that are lower for some enrollees than they were in 2017.

FL enrollment in qualified health plans

Despite the ACA’s cold reception among political leaders, Florida residents have taken advantage of the health insurance marketplace, with enrollment leading the nation.

By January 31, 2016, the end of 2016 open enrollment, Florida had enrolled more people than any other state and had the nation’s highest per-capita enrollment rate. As of March 31, 2016, Florida’s effectuated exchange enrollment stood at 1,531,714.

1,760,025 Florida residents enrolled in coverage through the exchange during the open enrollment period for 2017, again far outstripping the rest of the states.

And for 2018 coverage, Florida had 1,715,227 enrollees during open enrollment, again well ahead of the rest of the country. Open enrollment ended December 15, but people in Florida actually have until December 31 to sign up, due to the special enrollment period that was granted in response to the 2017 hurricane season.

Florida and the Affordable Care Act

In the 2010 vote on the Affordable Care Act, Florida’s senators split their votes. Democratic Sen. Bill Nelson voted yes, while Republican Sen. George LeMieux voted no. LeMieux briefly held the Senate seat after being appointed by then-Gov. Charlie Crist to serve out the remainder of Republican Sen. Mel Martinez, who retired. LeMieux left the Senate in 2011 and was replaced by Republican Marco Rubio. Rubio is opposed to the Affordable Care Act, and was instrumental in making the ACA’s risk corridor program retroactively budget-neutral, effectively dooming a number of smaller insurers across the country.

Among Florida’s delegation to the U.S. House of Representatives, 9 members voted in favor of the ACA, while 15 voted against the law. Republicans outnumber Democrats in the current delegation, 16 to 10.

The Affordable Care Act was not well received by state-level politicians in Florida. Gov. Rick Scott is vocally opposed to the healthcare reform law, and the state rejected federal loans to evaluate a state-run exchange, was the lead plaintiff in the U.S. Supreme Court case challenging the ACA, and rejected Medicaid expansion.

Florida Medicaid

Medicaid expansion was intended as one of the ACA’s main vehicles for reducing the number of people who lacked medical insurance coverage. However, the U.S. Supreme Court ruling in 2012 opened the door to many states, including Florida, to opt out of Medicaid expansion to single adults ages 19 to 64.

Florida’s decision not to expand Medicaid leaves 384,000 people in the coverage gap, meaning they do not qualify for Medicaid nor are they eligible for tax subsidies to help them afford private health insurance. According to the Kaiser Family Foundation, based on current eligibility for coverage, 702,000 people living in Florida would be eligible for Medicaid if the state expanded.

Since 2013, monthly Florida Medicaid enrollment as increased slightly by an average of 17 percent despite the state’s decision not to expand.

The Florida Department of Children and Families provides information about Florida’s health insurance assistance programs for low-income individuals and families.

Other ACA reform provisions

The Consumer Operated and Oriented Plan (CO-OP) Program is a provision of the Affordable Care Act. Through federal loans, the program encouraged start-up, nonprofit health insurers to enter the market and increase choice and competition. While no CO-OP plans were created in Florida, 23 private, nonprofit plans were set up across the country. Heading into 2018, only four were still offering coverage.

Medicare enrollment in the Sunshine State

Florida Medicare enrollment exceeded 4 million in 2015, about 20 percent of its population. Florida’s Medicare enrollment numbers are second only to California and the percentage of Florida residents enrolled in Medicare is higher than the 17 percent the total U.S. population enrolled in Medicare.

About 86 percent of Florida Medicare recipients qualify based on age alone, while the remainder are eligible as the result of a disability.

In 2014, Medicare spent about $10,610 per enrollee. The national average was $8,970 per enrollee. As of 2009, the latest available data, Florida ranked second in overall spending with $39.1 billion per year. California was first with $50.6 billion.

Florida residents who want additional benefits beyond those offered by Original Medicare can enroll in a Medicare Advantage plan. About 40 percent of Florida Medicare beneficiaries select a Medicare Advantage plan – about 32 percent of all U.S. Medicare beneficiaries make that selection. Thirty-five percent of Florida Medicare enrollees also select a Medicare Part D plan for stand-alone prescription drug coverage compared with 43 percent nationwide.

Florida health insurance resources

Florida reform at the state level

Here’s what’s happening legislatively at the state level with healthcare reform in Florida:

  • Florida lawmakers passed House Bill 221 on March 11, 2016, and Gov. Scott signed it into law in April, thereby banning the practice of balance billing in situations (including non-emergency care) where the patent uses an in-network hospital or urgent care facility and “does not have the ability or opportunity to choose a participating provider at the facility.” For emergency care, insurers are required to cover treatment at in-network rates, regardless of whether or not the providers are in-network and regardless of whether or not the patient could choose another provider.

Other state-level health reform legislation:

More Florida coverage

News, history, and enrollment info for your state marketplace

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