CHANGE IS HERE QUALITY HEALTH INSURANCE IS NOW WITHIN REACH. 1
Myth or Fact? Healthcare reform will only benefit families earning less than $45,000/yr. Myth 2
CHANGE IS HERE CONNECTICUT HAS A NEW HEALTH INSURANCE MARKETPLACE. 3
Myth or Fact? You can no longer be denied coverage if you have a pre-existing condition.* Fact * Does not apply to individual grandfathered health plans. 4
CHANGE IS HERE YOU MAY QUALIFY FOR TAX SAVINGS ON HEALTH INSURANCE. 5
Myth or Fact? If you qualify, the government may pay a large part of your monthly health insurance. Fact 6
CHANGE IS HERE KEY PREVENTIVE CARE SERVICES WILL BE COVERED FOR FREE. 7
Myth or Fact? There will be no penalty if you don t have health insurance in 2014. Myth 8
CT s New Health Insurance Marketplace: Big Changes, Big Savings, Big Benefits
Ready to help you Brokers Licensed insurance agents who can recommend plans and enroll you Assisters Trained community helpers who can give general guidance about plans 10
Change is here! New law Affordable Care Act New place to buy health insurance Access Health CT New ways to save money on health insurance 11
You will benefit from some very real changes. Can t be denied coverage due to a pre-existing condition * Can t be charged more based on your medical history No lifetime limits on most benefits you receive Key preventive services at no additional cost Children can stay on parents plan up to age 26 *Does not apply to individual grandfathered health plans. 12
Medicaid Expansion Under the Affordable Care Act More uninsured adults and families will now qualify for Medicaid Optional for states: Not all are implementing it, but Connecticut is Enroll in Medicaid through Access Health CT, if you qualify 13
Access Health CT: A New Way to Buy Health Insurance Carrier 1 Carrier 2 Carrier 3 14
Tax Savings from the Federal Government You Pay Government Pays 15
Access Health CT marketplace opens October 1, 2013. Only place for CT residents to get tax savings from government See if you qualify for Medicaid (and enroll if you do) Single place to compare plans and enroll online, by phone, or via agent Features name-brand insurance plans approved by CT Insurance Department 16
Access Health CT is for you if... Your employer doesn t insure you You work for yourself You ve been denied insurance due to a pre-existing condition You re insured but looking for cost savings And other situations 17
Why do you need health insurance? Protects you and your family against financial catastrophe - Cost of one-day inpatient hospital stay in CT: $2,154 - Majority of bankruptcies are related to medical bills 18
Why do you need health insurance? Helps you get the care you need so you re happier, healthier - Over half of uninsured don t have a regular source of health care - Uninsured more than twice as likely to delay or skip needed care - Uninsured less likely to have access to preventive care 19
Get covered or you may be required to pay a tax penalty. 2014 2015 2016 $95 or 1% of income, * whichever is greater $325 or 2% of income, * whichever is greater $695 or 2.5% of income, * whichever is greater FYI: 1% of $30,000 = $300 * Income over the individual s federal income tax return filing threshold 20
Do you qualify for tax savings (or Medicaid)? up to $94,200 up to $45,960 up to $15,856 Eligible for Tax Savings* Eligible for Medicaid* up to $32,499 Single Family of 4 * Eligibility will depend on actual income level and household size. 21
How much will you have to pay for quality health insurance? Maximum of 9.5% of your income Less if you qualify for tax savings as little as 2% or 3% Potentially free if you qualify for Medicaid 22
Real Life: Select a scenario below: Sophie & Raul Family of four Monique & Kevin Married couple C.J. Young man Jill Single mom 23
Real Life: Sophie & Raul Married Age: Both 36 Jobs: Beauty shop stylist and restaurant cook Income: $51,000
Real Life with Sophie and Raul In their 30s Family of four $51,000/yr Monthly Savings: $428 Monthly premium: $721* They pay: $293 Government pays: $428 *As of 8/1/13. Example based on estimates developed by the Congressional Budget Office. Premiums would fluctuate based on level of plan chosen. 25
Sophie gets the news from Raul. Average cost of managing diabetes: $7,900/year * * American Diabetes Association 26
What happens if they get health insurance Monthly premium: $721* They pay: $293 Government pays: $428 *As of 8/1/13. Example based on estimates developed by the Congressional Budget Office. Premiums would fluctuate based on level of plan chosen. 27
Average Costs for Other Care Hospital Stay $2,154/day Breast Cancer $23,078/year Heart Attack $34,286 28
Real Life: Monique & Kevin Married Ages: 43 and 45 Jobs: Piano teacher and mechanic Income: $62,000
Real Life with Monique and Kevin In their 40s $62,000/yr Monthly Savings: $330 Monthly premium: $821* They pay: $491 Government pays: $330 *As of 8/1/13. Example based on estimates developed by the Congressional Budget Office. Premiums would fluctuate based on level of plan chosen. 30
He gives Monique the news. Heart surgery could cost $30,000 or more* * Centers for Medicare and Medicaid Services 31
What if they get health insurance Monthly premium: $821* They pay: $491 Government pays: $330 *As of 8/1/13. Example based on estimates developed by the Congressional Budget Office. Premiums would fluctuate based on level of plan chosen. 32
Average Costs for Other Care Hospital Stay $2,154/day Breast Cancer $23,078/year Managing Diabetes $7,900/year 33
Real Life: C.J. Single Age: 27 Job: Construction worker Income: $23,000
Real Life with C.J. Age: 27 $23,000/yr Monthly Savings: $186 Monthly premium: $307* He pays: $121 Government pays: $186 *As of 8/1/13. Example based on estimates developed by the Congressional Budget Office. Premiums would fluctuate based on level of plan chosen. 35
C.J. gives his mom the news. She s not happy. The average oneday hospital stay costs $2,154* * Kaiser Family Foundation State Health Facts 36
What if he had health insurance Monthly premium: $307* He pays: $121 Government pays: $186 *As of 8/1/13. Example based on estimates developed by the Congressional Budget Office. Premiums would fluctuate based on level of plan chosen. 37
Average Costs for Other Care Managing Diabetes $7,900/year Breast Cancer $23,078/year Heart Attack $34,286 38
Real Life: Jill Single with one child Age: 49 Job: Bookkeeper Income: $38,000
Real Life with Jill Single mom in her 40s $38,000/yr Monthly Savings: $250 Monthly premium: $500* She pays: $250 Government pays: $250 *As of 8/1/13. Example based on estimates developed by the Congressional Budget Office. Premiums would fluctuate based on level of plan chosen. 40
Jill gets a reality check from her mom. Jill, I m worried. You re under all this stress. And that cough isn t going away. I know. But how can I afford to pay for any doctors or medication? 41
What if she had health insurance Monthly premium: $500* She pays: $250 Government pays: $250 *As of 8/1/13. Example based on estimates developed by the Congressional Budget Office. Premiums would fluctuate based on level of plan chosen. 42
Average Costs for Other Care Managing Diabetes $7,900/year Breast Cancer $23,078/year Heart Attack $34,286 43
Already insured? You may be able to save. $60,000 yearly income $13,000 current health insurance cost $5,700 health insurance cost with Access Health CT $7,300 savings 44
Find out what you might pay. 45
Enrollment Dates Open enrollment Coverage can begin as early as October 1 2013 March 31 2014 January 1 2014 46
Navigators and Assisters Program Starts October 1, 2013 Brings the health insurance marketplace directly to your community Support program to help educate and enroll you Help appropriate for your language and culture 47
Navigators and Assisters: How It Works Navigators - Existing community organizations - Covering different regions of CT - Support Assisters in their region Assisters - Trusted community members - Work one-on-one with people - Thoroughly trained - Have undergone background checks 48
Navigators and Assisters Across CT 49
Three Ways to Find an Assister (or Broker) Go to AccessHealthCT.com Visit an Enrollment Center Come to an Enrollment Fair 50
Enroll in person with Access Health CT. Enrollment Centers - New Britain - New Haven Enrollment Fairs - See the Events page at AccessHealthCT.com for dates and locations 51
Health Insurance in CT has changed. Test Your Knowledge 52
Soon you will have to buy health insurance. It s the law! Myth Fact 53
Soon you will have to buy health insurance. It s the law! Myth Fact 54
The government will now be your insurance provider. Myth Fact 55
The government will now be your insurance provider. Myth Fact 56
Only some health insurance plans will have to meet minimum requirements for benefits. Myth Fact 57
Only some health insurance plans will have to meet minimum requirements for benefits. Myth Fact 58
A family of four earning over $90,000 could qualify for savings on health insurance. Myth Fact 59
A family of four earning over $90,000 could qualify for savings on health insurance. Myth Fact 60
Don t wait! Start preparing now! Visit AccessHealthCT.com Review How to Enroll handout Keep an eye out for Enrollment Centers and Enrollment Fairs 61
People are already benefitting from some very real changes. Automatic eligibility - Can t be denied coverage due to a pre-existing condition Cost Reforms - Can t be charged more based on your medical history Thank You Extensive preventative services, such as physicals, at no cost No lifetime limits on the (dollar) amount of care you can receive Children can sty on parent s plan up to age 26
EL CAMBIO YA ESTA AQUÍ. La cobertura de atención médica de calidad ya está a su alcance! Inscribirse con Access Health CT PERIODO DE INSCRIPCION COMIENZA EL 01 DE OCTUBRE DEL 2013 Inscribirse para obtener cobertura de seguro de salud por medio de Access Health CT es muy sencillo, y con un poco de preparación puede serlo aún más. Por favor use este documento para prepararse. Cuándo debo inscribirme? A partir del 1ero de octubre del 2013 al 31 de marzo del 2014 (la cobertura comienza el 01 de enero del 2014, si usted se inscribe antes del 15 de diciembre) Como puedo inscribirme por medio de Access Health CT? Centros de Inscripción: Inscríbase en persona en nuestros centros ubicados en New Britain o New Haven. Visite AccessHealthCT.com periódicamente para enterarse de otros centros por abrir. Ferias de Inscripción: Suscríbase para recibir actualizaciones por correo electrónico en AccessHealthCT.com para enterarse de las Ferias de Inscripción en su área a partir de octubre del 2013. Teléfono: 1-855-805-4325 En línea: AccessHealthCT.com Qué información debe proporcionar? Las fechas de cumpleaños de todos los integrantes de la familia que necesitan cobertura. Los números de seguro social de todos los integrantes de la familia que necesitan cobertura (o números de documentos para inmigrantes legales). Estado de ciudadanía o inmigración. Declaraciones de impuestos de años anteriores. Información del empleador e ingresos de cada uno de los miembros de su hogar que necesitan cobertura (por ejemplo, el comprobante de pago de salarios de formularios W-2 y las declaraciones de impuestos). Información de cobertura del cuidado de la salud (números de póliza de cualquier plan de seguro médico actual que cubre a miembros de su familia). Quién puede ayudarme con la inscripción? Agentes de seguros Agentes de seguros con licencia que pueden recomendarle un plan e inscribirle sin costo adicional. Contacte a Access Health CT para encontrar a un agente cerca de usted. Los Agentes de Seguro puede que asistan también a Ferias de Inscripción en su área. Asistentes: Navegantes y Asistentes están certificados por Acccess Health CT para ayudarle con el proceso de inscripción. Ellos le pueden proporcionar orientación general sobre la cobertura de salud y ayuda para inscribirse.