Return to flip book view

NEED TO KNOW HEALTH INSURANCE 1 ACA AFFORDABLE CARE ACT 2 APTC CSR 3 JARGON 4 5 MEDICAID MEDICARE DON T FORGET TO RENEW EVERY FALL Find out more information www thecrownpoint com service thecrownpoint com

NEED TO KNOW ACA INSURANCE 1 2 ACA WHAT IT STANDS FOR Affordable Care Act most people know it as Obamacare There are no health questions and can be significant savings depending on your income It does have certain enrollment periods It can cover preventative services and mental health services 3 REQUIRED DOCUMENTATION Sometimes you can be required to submit additional documention You ll see this on your Eligibility Results The deadline is usually 90 days out However the sooner you complete this the better failing to comply can make tax credits stop DON T FORGET TO RENEW EVERY FALL DEADLINES ACA plans only start on the 1st make sure your application is submitted before the end of the month some states by the 15th Keep in mind ID cards usually take 3 5 business days to process 4 USING YOUR INSURANCE Make sure you stay in your plans network to get the best coverage When you have questions or concerns about your coverage just reach out to us we re here to have your back and answer your questions Find out more information www thecrownpoint com service thecrownpoint com

NEED TO KNOW APTC CSR 1 2 WHAT IT STANDS FOR APTC stands for Advanced Premium Tax Credit It is a tax credit you can use to lower your monthly insurance payment called your premium when you enroll in a plan through the Health Insurance Marketplace Use the income you expect to make this year Gross income unless you re self employe then Net income APTC will reconcile at tax time so do your best CSR stands for Cost Sharing Reduction it only works on Silver Plans 3 REQUIRED DOCUMENTATION Sometimes you can be required to submit additional documention You ll see this on your Eligibility Results The deadline is usually 90 days out However the sooner you complete this the better failing to comply can make tax credits stop DON T FORGET TO RENEW EVERY FALL INCOME 4 ELIGIBILITY Your projected income and household size will be reviewed if you qualify for APTC it applies to every plan If you also qualify for a CSR it will lower deductible copays coinsurance but only on Silver Plans Find out more information www thecrownpoint com service thecrownpoint com

NEED TO KNOW JARGON 1 2 DEDUCTIBLE The deductible is usually the amount that you must pay before the insurance company ends up paying Sometines only specific services apply to the deductible If a service is listed as deductible does not apply that means you get the copay or coinsurance amount even before your deductible is met 3 COPAY COINSURANCE Copay is a fixed dollar amount you ll know exactly what a service should cost For example a 40 specialist visit is a copay Coinsurance is a percentage Your expense will depend on what the doctor charges For example 20 of the bill at the ER is coinsurance DON T FORGET TO RENEW EVERY FALL PREMIUM The premium is the amount you pay every month It usually is required up front to start the plan Sometimes you can pay with a credit card but not always so be ready 4 MAX OUT OF POCKET The Max Out of Pocket is one of the biggest protections This determined the max you could spend Premiums do not count but they add up all deductible copay coinsurance expenses to count towards it Once you hit it they cover 100 of covered services Find out more information www thecrownpoint com service thecrownpoint com

NEED TO KNOW MEDICARE 1 2 ELIGIBILITY There is only a few ways to be eligible for Medicare The most common way to become eligible is by age turning 65 Other ways include receiving Social Security Disability payments for 24 months or being diagnosed with EndStage Renal Disease ALS also known as Lou Gehrig s disease 3 PARTS A B C D Part A is hospital coverage Part B is Doctor coverage Part C is Medicare Advantage plans Part D is Prescription Drug Plans Other letters you ll come across are usually Plan G and Plan N these are Medicare Supplement or Medigap plans DON T FORGET TO RENEW EVERY FALL COST In most cases Part A has already been paid through working and paying taxes Part B varies but starts around 165 per month Medigap Part C and Part D can all carry additional costs 4 LATE ENROLLMENT PENALTIES Late Enrollment Penalties only happen if you go without coverage at least as good as Medicare Penalties start accumulating after 63 days without Part D coverage and 12 months without Part B Any penalty accrued follows you for life and the actual dollar amount can vary Find out more information www thecrownpoint com service thecrownpoint com

NEED TO KNOW MEDICAID 1 2 ELIGIBILITY The Department of Health and Human Services DHHS determines Medicaid financial eligibility and all non financial eligibility including disability determinations They look at things like income assets and residency There are different qualifications for different age groups 3 RECERTIFICATION Every so often Medicaid wants you to verify income assets residency and a few other things They will usually mail you these requests Make sure you keep your address updated so you don t miss these requests DON T FORGET TO RENEW EVERY FALL COST If you qualify for full Medicaid you should have no costs for coverage or services If you qualify with a Spend Down you will have to spend that amount before the coverage kicks in 4 NO LONGER ELIGIBLE If you find yourself no longer eligible for Medicaid this creates a short window where you can pick up new coverage This coverage usually only starts on the 1st so make sure to start looking at options as soon as you find out you might be losing Medicaid coverage Find out more information www thecrownpoint com service thecrownpoint com