Wednesday, August 26, 2015

The "New" ACA

The ACA has been around since 2010

The Affordable Care Act
But the effects have really been seen since 2013. There has been a huge drop in the uninsured rate (now below 10%) down from over 14%. Millions have entered the marketplace to gain a tax credit that can be used for reducing the cost of health insurance.

The 2 big questions that most people have is..

1. How does the tax credit work?
2. Can I still afford coverage?


I'll break this down a little further so hopefully you will get a better understanding of the basic workings of the ACA (Obamacare).

How does the tax credit work?

   There is an algorithm that is in place that will tell you how much you can receive in a tax credit. The tax credit is given in two ways. 1.A one lump sum at the end of the year as a refund or 2.A monthly credit paid to the insurance carrier you chose to go with. You then are responsible for the difference and pay that difference to your insurance carrier.
The way the tax credit works is based on 4 things.
-Age
-Sex
-Zipcode (geographical location)
-Income

So, for instance, a couple that is 35, making 45000.00 per year living in West Allis WI would get Approximately 290.00 for a monthly tax credit they can use towards their health insurance.  But, A couple that is 61, making the same amount, living in West Allis WI would get Approximately 1115.00 for a monthly tax credit. Why the difference? I'm glad you asked! To make health insurance "affordable" you will need to adjust the credit accordingly.  The credit is based on the "average" cost of the second highest bronze plan that is available in your area. Statistically, the older you get the more health issues you have, the cost of insurance goes up dramatically and so does the tax credit to keep it in line with affordability. Women will always pay a little more to off set the cost of pregnancy and you location has a small effect as well. To summarize, unless your a Nobel Peace Prize winner in mathematics and want to figure it out yourself, you can get an idea by going to Healthcare.gov

Can I still afford coverage?

The answer to that question is kind of open ended, but my answer to you would be, yes, "mostly".
I ask all of my prospective clients "What is your budget?"  I have been able to find a comprehensive 
plan that fits that budget 95% of the time. although biggest part of that equation is the budget that a person has to use for health insurance, another part of that equation is the health of a person. Having health problems increases your premium in a round about way. You will need lower deductibles and lower out of pocket costs compared to someone with no health problems. The best way to find out if you really can afford coverage is to talk to a local agent. Someone who knows the in's and out's of plans available to you. Don't write off your health insurance because you think you might not be able to afford it. I have talked to many clients that said they wished they talked to me months ago! So, the answer to the Million dollar question is.... Talk to an agent, discuss your situation and have them counsel you on your best options.  Ultimately, it is your choice.

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