Young Invincibles Meet Obamacare: What You Need To Know.

Posted on | August 21, 2013 | 1 Comment

Mike Magee

This week, across America, college age kids are beginning to pack up and get ready to head back to college. They are part of a larger band of young, primarily healthy, and until now, largely uninsured citizens. That’s about to change with the institution of Obamacare. What do they need to know?

First, a few facts. An estimated 19 million Americans between age 18 and 34 currently have no health insurances. Demographers have labelled them as the “Young Invincibles”, but of course they are not invincible. Though the percentage is small, they are vulnerable to a rare medical or surgical events, an accident, or mental health emergency. That said, as a group they are a largely well population, which is to say “low cost”. This is critical when attempting to manage the chronic disease burden of older Americans and move toward universal health coverage without breaking the bank.

One of the cornerstones of the Patient Protection and Affordable Care Act or Obamacare is “shared responsibility”. The act contains both carrots and sticks in coaxing “Young Invincibles” to deal with their uninsured status. Carrots included more choices, more access and more transparency through the new Health Exchanges – both federal and state – that will offer coverage. The major stick is a financial penalty is you fail to get approved health insurance.

What are the facts for “Young Invincibles seeking insurance or trying to avoid penalties?

1. When is the due date?

Coverage will take effect on January 1, 2014. Sign up begins on October 1, 2013 with a six month open enrollment this first year extending until March 31, 2014.

2. Where and how do I sign up?

You can sign up using the Internet, phone, mail or in person at designated centers. Contact information is available at Healthcare.gov or at 1-800-318-2596 (a live person will answer and address any questions you have). After making your selection, it generally takes two weeks for your insurance to become effective.

3. Is everyone required to be insured?

No, students who are not fully employed and earn less than $10,000 a year do not have to sign up for health insurance.

4. What if you can’t afford to pay?

If you earn less than about $15,000 a year, and your state has agreed to expanding their Medicaid insurance, you may be eligible for Medicaid insurance. If you fall between 100% and 400% of the poverty level – that’s about $23,000 for one person or $94,000 for a family – you can qualify for lower cost insurance through the Health Exchange.

5. What if I already have coverage?

If you have insurance through your family (you can stay on this now until you are age 26), your family’s employer, or through the government (as with Medicare or Medicaid), you do not have to take any action. Insurance though a college or university qualifies as well.

6. What does insurance through one of these exchanges cover?

There are five different levels of care you can chose from with different prices. All plans must at least cover basic care including pediatric care, maternity care, doctor’s visits, prescription medications, hospitalization, mental health and substance abuse.

7. If I am healthy, do I pay the same amount as an older person who has medical problems?

No. The cost of insurance can vary according to four factors – age, tobacco use, geographic area and family size. Older people may be asked to pay three times the amount of younger people, and smokers may have to pay 50% more than non smokers.

8. What are the five levels of insurance I can choose from?

First, there’s a catastrophic low-cost plan that’s specifically available to those under 30. It provides only the basics in coverage but protects you against extreme costs. In addition there are four other plans – bronze, silver, gold and platinum. Of the four, bronze is the lowest cost with high out-of-pocket costs if you do seek care. Silver, gold and platinum offer progressively lower deductibles and co-payments in exchange for higher premium costs.

9. Is there a way to predict how much this will cost me?

Yes. Kaiser Family Foundation has an online tool (http://kff.org/interactive/subsidy-calculator/) that allows you to calculate your cost.

10. What is the penalty if I don’t get insurance, and how will the government even know?

The penalty for 2014 is $95 or 1% of your taxable income (whichever is greater). On your 2014 tax return, due April 15, 2015, you must check off whether or not you have qualified health insurance. If you do not have coverage, you will be assessed the penalty. If your income is so low that you don’t need to file a return, you are not required to have coverage and do not need to complete any other forms.

For more questions and answers? Go HERE.

For Health Commentary, I’m Mike Magee

Comments

One Response to “Young Invincibles Meet Obamacare: What You Need To Know.”

stress relief
March 11th, 2014 @ 1:52 pm

Wow that was odd. I just wrote an incredibly long comment but after I clicked
submit my comment didn’t appear. Grrrr… well I’m not writing all that over again.
Regardless, just wanted to say great blog!