Health Care Reform

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 days left in open enrollment

What do I need to know?

Here's what you need to know…

The Affordable Care Act (ACA) has significantly changed the U.S. health care system, bringing guaranteed issue of coverage, tax credits, and the Health Insurance Marketplace. Here's what Kansans like you need to know right now:

Quality coverage for all

The ACA provides greater access to health insurance by making it possible for anyone, regardless of their current or previous health condition, to purchase health insurance. It also mandates that all plans offered on the Marketplace include the same essential health benefits and preventive services.

Essential health benefits

No matter what plan you purchase, you are guaranteed to have essential health benefits including coverage for: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse disorders, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive and wellness services, chronic disease management, and pediatric services, including oral and vision care.

Preventive services

Plans sold on the Marketplace also include preventive services you can receive with no cost-sharing involved. So things like breast and colon cancer screenings, screening for diabetes, blood pressure and high cholesterol, and routine vaccinations will all be provided without you having to pay a copay, deductible or coinsurance as long as the primary purpose of the visit was for the recommended preventive service.

You may get financial assistance

A number of Kansans will qualify for government assistance through an Advanced Premium Tax Credit Adobe Acrobat PDF or cost-sharing reductions. The tax credit is applied directly to your monthly payments.

You may face a penalty if you don't enroll

This federal income tax penalty would either be two percent of your household income that is above the tax return threshold for your filing status, or a flat dollar amount of $325 per adult and $162.50 per child (maximum of $975), whichever is greater. This is a substantial increase from last year's income tax penalty.

How do I get insurance?

It's easy! Here's how…
Shop the MarketplaceShop our website
Already know what you want?

You can purchase a plan directly from us!

Blue Cross and Blue Shield of Kansas provides many options to help put you in control of your health care. When you choose a health insurance plan, you want to get the most out of your health care dollars. That is why you can purchase a plan directly from us with a short application process you can complete online!

You'll find us on the Marketplace

If you're eligible for a tax credit, you'll need to go through the Marketplace. Benefits and pricing are the same, and you will have several options to consider.

Finding a plan that fits

Health insurance plans offered through the Marketplace and Blue Cross and Blue Shield of Kansas have different levels of coverage called “Metal Levels Adobe Acrobat PDF.” Levels are defined by the amount you pay in monthly premiums and how much your plan pays when you need care.

What if I need coverage after enrollment ends?

Open enrollment period ends Feb. 15, 2015. After this date, you can still get coverage under special enrollment periods for life changing events such as:

  • Marriage
  • Birth
  • Adoption
  • Loss of other coverage

How do I get an advanced premium tax credit?

What is the advanced premium tax credit?

The advanced premium tax credit

The premium tax credit Adobe Acrobat PDF is an advance, refundable tax credit designed to help eligible individuals and families with low or moderate income afford health insurance purchased through the Marketplace. You can choose to have the credit paid in advance to your insurance company to lower what you pay for your monthly premiums, or you can claim all of the credit when you file your tax return for the year.

Income requirements

The benefit levels of many government assistance programs are based on federal poverty levels Adobe Acrobat PDF (FPL). You would be eligible for tax credits if your income falls between 100 percent and 400 percent of the FPL.

Eligibility

You are eligible for the premium tax credit if you meet all of the following requirements:

  • Purchase coverage through the Marketplace
  • Have household income that falls between 100 percent and 400 percent of the federal poverty level
  • Are not able to get coverage through a government program like Medicaid, Medicare, CHIP or TRICARE
  • File a joint return, if married
  • Cannot be claimed as a dependent by another person
  • Do not have access to qualified coverage through an employer

General resources

Here's some other things you might find helpful…
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