The Times West Virginian

West Virginia

September 29, 2013

Key questions answered about health care exchange

MORGANTOWN — Starting Tuesday, people in West Virginia who currently have no health insurance can sign up for coverage under a health care exchange — a state and federal partnership.

Coverage will kick in Jan. 1, 2014, and the U.S. Department of Health and Human Services predicts that six in 10 people will be able to find at least some level of coverage for $100 or less per month, after tax credits.

But low premiums have a

trade-off: They could lead to big out-of-pocket expenses later when medical bills exceed the amount that insurers consider reasonable.

Here’s some information to help you get started.

How many West Virginians lack health insurance?

An estimated 254,000 are uninsured, according to U.S. Census Bureau data. That’s nearly 14 percent of the population.

What is a health care exchange?

It’s created by the federal Affordable Care Act. The online marketplace allows for side-by-side comparison of coverage options before enrolling.

Who is selling it in West Virginia?

Highmark Blue Cross Blue Shield is offering 11 plans in the individual market and four plans in the small business marketplace. People can choose from four levels of coverage — bronze, silver, gold and platinum. The big difference is cost sharing. Bronze plans have the lowest premiums, while platinum have the highest. But low premiums could result in big bills later if your expenses exceed what’s considered reasonable.

How much will it cost?

A chart provided by the Obama administration gives two examples.

A 27-year-old man making $25,000 a year would, on average, pay a monthly premium of $342 for the midrange silver plan. After tax credits, that premium could drop to $145. If the person opted for the bronze plan, his cost would drop to $90.

For a family of four making $50,000, premiums on the midrange silver plan would average $1,237 a month before tax credits but drop to $282 with them. If the family went with the bronze plan, the cost would be $81 a month.

Why should I sign up?

If the government decides you can afford health insurance and you don’t have it by 2014, you may have to pay a fee. You also have to pay 100 percent of your medical bills on your own.

The fee is 1 percent of your yearly income, or $95 per person for the year, whichever is higher. For children, it’s $47.50 per child, up to $285 total.

The fee increases every year. In 2016, it will be 2.5 percent of income, or $695 per person, whichever is higher.

What if i am on Medicare?

Medicare beneficiaries don’t have to do anything differently.

What about Medicaid?

West Virginia is expanding Medicaid up to 138 percent of the federal poverty level on Jan. 1, so any resident who earns less than $15,800 and is younger than 65 will be eligible. That’s believed to be about 133,500 low-income residents.

How are my children affected?

Kids currently eligible for the federal Children’s Health Insurance Program will remain eligible through 2019. The Affordable Care Act includes more money to get people enrolled in both Medicaid and CHIP.

Can someone help me?

West Virginia will have navigators, independent counselors who work under federal grants to help you and your family find the best coverage plan. Many hospitals and health care facilities will have on-site navigators, and information about other places to find them will be coming out soon.

Where can I learn more?

Go to a county office of the Department of Health and Human Resources, or call 1-800-318-2596.

Health Insurance Marketplace: http://bewv.wvinsurance.gov/

West Virginians for Affordable Health Care: http://www.wvahc

1
Text Only
West Virginia
  • Manchin urges mines to speak out for coal

    The Democratic senator leading the battle against the White House’s strategy to fight climate change urged the mining industry on Tuesday to speak out about coal’s role in providing affordable, reliable electricity to the country to help combat strict new emissions rules for coal-fired power plants.

    April 16, 2014

  • Many schools already meet new mandate for breakfast

    Many West Virginia public schools have changed the way they serve breakfast to students ahead of a requirement that goes into effect in September.

    April 14, 2014

  • W.Va. grower promotes unmodified feed corn

    Lyle Tabb is hoping that his non-genetically modified corn will take off with farmers who can charge top dollar for “all natural” eggs.
    Genetically modified or GMO corn has greatly simplified the process of getting rid of weeds, but has also substantially increased the amount of a chemical call glyphosate.

    April 13, 2014

  • Geologists link small quakes to fracking

    Geologists in Ohio have for the first time linked earthquakes in a geologic formation deep under the Appalachians to hydraulic fracturing, leading the state to issue new permit conditions Friday in certain areas that are among the nation’s strictest.
    A state investigation of five small tremors last month in the Youngstown area, in the Appalachian foothills, found the injection of sand and water that accompanies hydraulic fracturing, or fracking, in the Utica shale may have increased pressure on a small, unknown fault, said State Oil & Gas Chief Rick Simmers. He called the link “probable.”

    April 12, 2014

  • Phares looks forward to retirement

    James Phares looked forward to the challenge and opportunity to help make a difference in a state education system under fire when he was hired in late 2012 as West Virginia’s schools superintendent.
    After 18 months, Phares will be stepping down on June 30 — which he said was set long ago as the day at age 61 that he’d walk with his wife into retirement.

    April 11, 2014

  • Teacher planning, abortion ban among W.Va. vetoes

    Gov. Earl Ray Tomblin signed about 200 bills and nixed eight this year, leaving teachers and abortion opponents unsatisfied.

    April 7, 2014

  • Spill company president ‘bears no fault’

    The president of Freedom Industries “bears no fault” for a West Virginia chemical spill that spurred a water-use ban for up to 10 days for 300,000 people, his lawyer says in a court filing.
    On Friday, Freedom President Gary Southern withdrew his application to get paid for work he already did during the company’s bankruptcy proceedings. He also wanted Freedom and its insurance to cover his legal fees related to the Jan. 9 spill.

    April 5, 2014

  • Agencies to ask West Virginia residents about chemical spill

    Health agencies are making thousands of phone calls and going door-to-door to ask West Virginians how a January chemical spill affected them.
    The state Bureau for Public Health announced Thursday that volunteers will survey randomly selected households in nine counties about health concerns from the spill.

    April 5, 2014

  • Hearing scheduled on police shooting suit dispute

    The family of a Virginia man who was shot and killed by Martinsburg police officers after a scuffle is asking a judge to order the city to give them investigative and autopsy reports from the incident.
    The estate of 50-year-old Wayne Arnold Jones of Stephens City, Va., filed a $200 million federal lawsuit against the city after he was killed on March 13, 2013.

    April 4, 2014

  • Families remember mine disaster victims

    Four years after losing friends and relatives in a West Virginia mine disaster, 11 people preferred to watch a film together that they knew would reopen those wounds.
    The film, “Upper Big Branch - Never Again,” by former Massey Energy CEO Don Blankenship theorized that his old company wasn’t at fault for the deadly explosion, despite four investigations that concluded otherwise.

    April 3, 2014

House Ads
Featured Ads