Health Insurance

Understanding the Health Insurance Marketplace

 

With all the talk about health care insurance changes, sometimes it is difficult to know how the changes will really affect you.  This page was created to address the most frequently asked questions.

If you have a question for something for which you do not see an answer, please call us at the number at the top of this webpage.

 

Below are Frequently Asked Questions (FAQ's) we think will help you understand our services and how to contact us.

 

Frequently Asked Questions

What is the Health Insurance Marketplace?

"Marketplace" is the word used for places where Americans will be buying health insurance from health care companies. Buying health insurance will be like you have been buying car insurance. The amount of money you make will be used to determine if you will be part of the Marketplace.

 

Who can be part of the Marketplace?

Anybody can be part of the marketplace. However, if your employer offers you coverage, it may be cheaper to stay with your employer’s coverage.

A particular advantage of the marketplace is the availability of financial assistance to help pay for premiums as well as out-of-pocket expenses. However, the premium financial assistance is only available if you fall within 400% of the federal poverty level. The out-of-pocket assistance is only available for those whose income is below 250% of the federal poverty level.

 

Who will not be part of the Marketplace?

People who can't be part of the Marketplace include any who qualify for Medicaid, people who choose to keep their private insurance, people who choose to pay tax instead of buying health insurance and some other exceptions.

 

How will the Federal Government Marketplace work?

The Marketplace is a website. The website is healthcare.gov. Buying health insurance through the Marketplace is like buying car insurance. Different health insurance companies will try to show you how their insurance company is the one you should choose. Just like when you buy car insurance, you will be able to see what the different health insurance companies have to offer.

 

What kinds of services does the Government say must be part of the Marketplace?

  • Outpatient
  • Emergency
  • Hospital
  • Maternity and Newborn Care
  • Mental Health/Substance Abuse
  • Prescription Drugs
  • Rehabilitation
  • Habilitative (daily living)
  • Laboratory
  • Preventive and Wellness
  • Pediatric (Oral and Vision Care)
  • Chronic Disease Management

 

How much will health insurance on the Marketplace cost?

It is difficult to say how much your insurance will cost you, until you complete your application on healthcare.gov.

Your health insurance costs are determined by your income and the specific plan you choose. Platinum, Gold, Silver, and Bronze “metal” plans offer various premium and out-of-pocket expenses that you may choose from. You may also be eligible for financial assistance to help pay your premiums and out-of-pocket expenses.

 

What kinds of insurance plans will be part of the Marketplace?

Southeast Wisconsin currently has 4 health insurance companies that are part of the Marketplace. Each of these companies will offer at least one Silver plan and one Gold plan.

  • Platinum = Highest premium price, lowest deductibles
  • Gold = High premium price, low deductibles
  • Silver = Average premium price, average deductibles
  • Bronze = Lowest premium price, highest deductibles

 

 

When does health insurance begin when I buy it through the Marketplace?

You can begin buying coverage on October 1, 2013 but coverage will not begin until January 1, 2014.

 

If I sign up for the Marketplace, how can I lower my payments?

After you choose a health insurance company, you can ask for tax credit on the sign up paperwork. The tax credit will be sent to your health insurance company and they will use that money to lower your payment to them. The tax credits will be different depending on the size of your family and your income.

 

How do I buy health insurance through the Marketplace?

The marketplace is available at healthcare.gov. This website will allow you to complete an application for health insurance. It will also determine whether you are eligible for the marketplace or BadgerCare. If you are eligible for the Marketplace, it will also show you your premium cost, your financial assistance, and all of the plans available for you.

 

Contact an Outreach & Enrollment Specialist at KCHC can help you through this process through our contact form or by calling us at the number at on this webpage.

 

When can I begin shopping for health insurance on the Marketplace?

You can begin buying coverage on October 1, 2013.

 
 

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KENOSHA COMMUNITY HEALTH CENTER, INC is a Deemed facility by The Health Resources and Services Administration (HRSA), in accordance with the Federally Supported Health Centers Assistance Act (FSHCAA), as amended, sections 224(g)-(n) of the Public Health Service (PHS) Act, U.S.C. §§ 233(g)-(n). As such, KCHC is an employee of the PHS, for the purposes of section 224.

Kenosha Community Health Center, Admin Bldg, 625 57th Street, Ste. 700, Kenosha, WI 53140
(262) 656-0044