The Kaiser Family Foundation is a nonprofit, non-partisan group that develops healthcare research and provides the facts and findings to the public, free of charge.
Kaiser’s subsidy calculator allows users to enter different income levels, family sizes, and ages to get an estimate of the eligibility or savings someone could expect from purchasing healthcare coverage.
Depending on how much money you earn and the number of people in your family, you may be able to get help paying for your health insurance and your out-of-pocket costs. A monthly premium tax credit lowers the cost of your monthly insurance premium. You qualify if your household income is less than 400 percent of the federal poverty level. Also, you may qualify for lower out-of-pocket expenses (i.e. copayments, coinsurance, and deductibles) if your household income is less than 250 percent of the federal poverty level.
You can use the Kaiser Family Foundation’s calculator to determine if you are eligible for financial assistance. Keep in mind the Kaiser Family Foundation bases its calculations on silver plan rates, though less expensive plans are available.
You will only be eligible to receive the tax break or subsidy if you purchase your health insurance on Your Health Idaho.
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.
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