Affordable Care Act
The federal Affordable Care Act (ACA) requires each state to operate a Health Insurance Marketplace, also known as an exchange, where people may purchase coverage. The 2016 open enrollment period is November 1, 2015 through January 31, 2016. Coverage would begin on January 1, 2016.
Through the online Health Insurance Marketplace, non-Medicare eligible consumers will be able to compare plans, prices and health-care providers. The primary goal of the ACA is to provide access to the uninsured and to provide a competitive marketplace for plan premiums and coverage.
Information and sign-up for the Affordable Care Act can be found at Healthcare.gov
There are four main points for ASRS retirees to consider:
- The ASRS retiree health insurance program meets the health care requirements outlined by the Affordable Care Act.
- If you are not eligible for Medicare and have health insurance through the ASRS retiree health insurance program, you now have additional options through the Affordable Care Act. You may review the available ACA options through the Health Insurance Marketplace to determine if they better suit your personal needs for health insurance.
- If you are not eligible for Medicare and do not now participate in an ASRS retiree health insurance plan, or otherwise have no health insurance, in most cases you will be required to obtain coverage or pay a penalty. Depending on your household income, you and your eligible dependents may be eligible for a government subsidy to help you pay for coverage through the Health Insurance Marketplace.
- If you are eligible for Medicare and participate in a Medicare plan, either through the ASRS or some other option, the new Health Insurance Marketplace does not apply to you.
Affordable Care Act Q & A
Q: What is the Health Insurance Marketplace?
Q: What is the difference between the tax credit and cost-sharing subsidies?
Q: How does the Health Insurance Marketplace affect me as a non-Medicare member?
Q: How does the Health Insurance Marketplace affect me as a Medicare eligible member?
Q: Will my ASRS coverage change (i.e. less services covered, copayments change) because of the ACA?
Q: Will the ASRS premium benefit be applied to insurance purchased through the ACA Health Insurance Marketplace?
Q: If I drop my insurance purchased through the Health Insurance Marketplace, is that a Qualifying Event that would allow me to enroll in ASRS insurance outside of open enrollment?
Q: Why do monthly premiums vary within the Marketplace compared to ASRS?
- With a Bronze plan, you will likely pay a lower premium, but pay a higher share of costs when you receive care.
- Platinum plans will likely have the highest monthly premiums and lowest out-of-pocket costs. The plan will pay more of the costs if you need a lot of medical care.
- In general, when choosing your health plan, keep this in mind: the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium, the lower the out-of-pocket costs when you need care.