MARKETPLACE

 

THERE IS A NEW MARKETPLACE FOR EACH STATE WHERE PEOPLE CAN GET FREE OR LOW COST HEALTH INSURANCE.

Each state has a Marketplace where you can set up an account (user name and password) and apply for insurance. The cost of health insurance is based on income and family size. The federal government offers tax credits to pay part or all of the premiums in the Marketplace. When you apply for health insurance, you will find out the amount of your tax credits. Advanced payment of tax credits (APTC) can be sent directly to the insurance company to pay the monthly premiums.

 

EVERY PLAN ON THE MARKETPLACE HAS TWO VARIATIONS FOR AMERICAN INDIANS AND ALASKA NATIVES:

1. Zero cost sharing plans: If your income is below 300 percent of the federal poverty level, you can get health care anywhere without co-pays or deductibles.

2. Limited cost sharing plans: If your income is above 300 percent of the federal poverty level or there is no income determination on the application, and you have a referral from your Indian health provider (such as a Contract Health Services referral), there will be no co-pays or deductibles.

AMERICAN INDIANS AND ALASKA NATIVES CAN USE THE FEDERAL TAX CREDITS TO PURCHASE LESS EXPENSIVE BRONZE LEVEL PLANS.

The federal government offers tax credits to pay for premiums based on the second lowest cost silver plan. Enrolled members of federally-recognized Tribes and shareholders in Alaska Native corporations have a special provision in the law where they can apply the tax credits to purchase lower cost bronze plans and still get the zero or limited cost sharing plans. For some people, this will mean that private health insurance is free.

MONTHLY ENROLLMENT PERIODS MAKE IT FOR AMERICAN INDIANS AND ALASKA NATIVES TO GET HEALTH INSURANCE THROUGH THE MARKETPLACE.

There are special enrollment periods for American Indians and Alaska Natives every month. If you enroll in insurance by the 15th day of the month, your coverage will begin on the first day of the next month. This allows you to change plans if you enroll in a plan that does not have the providers that you want.

To receive these benefits, you must be an enrolled member of a federally recognized Tribe or a shareholder in an Alaska Native Regional or Village Corporation.

THE MARKETPLACE IN YOUR STATE MAY HAVE A DIFFERENT NAME.

States that operate their own Marketplaces usually have a unique name. Find out more about the Marketplace in your state. Go to the website www.healthcare.gov/marketplace/individual and enter your state in the drop down box.

DENTAL PLANS ARE OFFERED ON THE MARKETPLACE.

The Affordable Care Act (ACA) requires health insurance plans to include dental coverage for kids up to 19 years old. These are usually offered as Stand Alone Dental Plans (SADP).  Tax credits apply to SADP. Adult plans may also be offered as SADP on the Marketplace, but these do not have tax credits. There is no tax penalty if people do not purchase the SADP. The rules about cost sharing for AI/AN in SADPs for children are different from the QHPs, as there are no zero or limited cost sharing plan variations for SADPs.

 

VIDEO:
Native Americans and Health Insurance Exchanges
by Brenton Bluehouse