Start here! What's the tax credit and what are my options?
As of January 2014, everyone is required to have health insurance. Your Health Idaho offers individuals and families, who don’t have coverage through an employer or the government, a way to shop for health insurance. You may even qualify for a tax credit that pays for a portion (or even all) of your monthly insurance .
Do you qualify for a Special Enrollment Period?
While the open enrollment period ended March 31, there are life events that will allow you to enter a special enrollment period (SEP). We have listed below some of the more common events that will trigger an SEP, allowing you to change or purchase a qualified health plan.
Please note: this information provided is a general overview of the rules and regulations of the ACA. It may not address every specific situation you face, and is not intended to be legal advice.
The following examples are qualifying events that allow you to change coverage outside of the open enrollment period:
Birth, adoption, or placement of foster child
Involuntary loss of health insurance
Covered dependent turns 26
Death of the policy holder
Divorce or legal separation
Permanent move to an area served by Your Health Idaho
Ready to shop for health insurance?
Click the link below to go to Your Health Idaho. You can see all your coverage options, apply for the tax credit, and enroll in a new plan.
Open enrollment is closed, but you can find out if you qualify for a and get ready for the upcoming open enrollment period.
Starting in 2014, you must be enrolled in a health insurance plan that meets basic minimum standards. If you aren’t, you may be required to pay a tax penalty. This penalty will be either 1% of your taxable income OR a flat dollar amount – whichever amount is greater. The flat dollar amount will increase every year you are without health insurance. It starts at $95 in 2014, $325 in 2015 and $695 in 2016. You won’t have to pay a penalty if you have very low income and coverage is unaffordable to you or for other reasons, including your religious beliefs. You will also be able to apply for a waiver asking not to pay an assessment if you don’t qualify automatically. More information can be found here: http://healthreform.kff.org/the-basics/requirement-to-buy-coverage-flowchart.aspx
Your Health Idaho is designed to make buying health coverage easier and more affordable. Your Health Idaho is an online portal where a variety of insurance providers will offer their products for you to consider and select a coverage plan that best fits your healthcare needs and your budget. Starting in 2013, Your Health Idaho will allow individuals to compare health plans, get answers to questions, find out if they are eligible for tax credits, and enroll in a health plan that meets their needs.
The four levels of individual coverage available through Your Health Idaho plans, called bronze, silver, gold and platinum. All plans will cover the essential benefits. Bronze plans will feature the lowest monthly premiums, but cover only 60 percent of average costs. Platinum plans will cover 90 percent of expected costs.
The amount you pay monthly for a health insurance plan.
A percentage of costs once you've hit your deductible and your insurance kicks in.
The amount you pay each year for out-of-pocket expenses before the health insurance plan picks up expenses.
Money you pay for health-related services in addition to your monthly premium. Depending on your health insurance plan, these may include an annual deductible, coinsurance, and copayments for doctor visits and prescriptions.
A flat fee, out-of-pocket expense that your plan specifies for health-related services such as a doctor visit, emergency room visit, or prescription medication.
Basic health benefits that most health insurance plans will have to cover starting in 2014 with no coverage limit. They include: office visits, emergency services, hospitalization, rehab care, mental health and substance abuse treatment, prescriptions, lab tests, prevention, maternal and newborn care, and pediatric care. Learn more about essential health benefits here: http://www.healthcare.gov/news/factsheets/2012/11/ehb11202012a.html.
When enrollment through Your Health Idaho starts in October 2013, individuals and families may be eligible for a new kind of tax credit to lower what they pay for their monthly health plan premiums. The premium tax credit will be paid in advance to your insurance company to help cover the cost of premiums, helping make insurance more affordable.
You'll be able to buy insurance through Your Health Idaho or from an insurance company, but the tax credits to help pay for insurance will be available only if you purchase through Your Health Idaho.
The Federal Poverty Level is a measure of income level issued annually by the Department of Health and Human Services. Federal poverty levels are used to determine your eligibility for certain programs and benefits. Incomes between 100 and 400 percent of the FPL ($11,490 - $45,960 for an individual) are eligible for the tax credit and those with incomes from 100 through 250 percent of FPL may be eligible for the cost sharing subsidy.
A fixed dollar amount that is the most you will pay for deductibles and coinsurance for most covered services in the course of a benefit period. Once the out-of-pocket maximum is met, most covered services are paid at 100 percent of the allowed amount.
The time outside an open enrollment period when you and your family can apply for health insurance. Special enrollments happen after some life events like marriage, birth of a child, moving to a new area, or a loss in other health coverage.
A collaboration between Blue Cross of Idaho and the Idaho Library Association to help educate all Idahoans about the coming changes to health insurance.For more information on Blue Cross of Idaho's products, visit bcidaho.com or call 888-462-7677.