11,000 Blount residents eligible for Health Insurance Marketplace
By Matthew Stewart | (firstname.lastname@example.org)
Of the nearly 19,000 uninsured Blount County residents, more than 11,000 are eligible for coverage through the Health Insurance Marketplace.
Eligible Americans will be able to enroll starting Oct. 1 in a health insurance plan and get coverage that starts Jan. 1, 2014. They can compare insurance options based on price, benefits, quality and other factors with a clear picture of premiums and cost-sharing amounts to help them choose the insurance that best fits their needs.
Financial assistance is available for people who qualify. Consumers may be eligible for a free or low-cost plan, or savings that lower monthly premiums.
As the first open enrollment period draws nearer, recent polls indicate that 80 percent of Americans don’t know they’re eligible for coverage. Organizations, such as the Tennessee Health Care Campaign, are working to direct people toward enrollment resources in order to maximize the number of individuals who will gain healthcare coverage.
BlueCross BlueShield of Tennessee, Community Health Alliance and Humana have applied for the Knoxville area, said Laura Sell, Blount Health Care Coalition volunteer. The companies are expected to publish their health insurance plans within the next couple weeks.
All Marketplace plans will offer the same set of essential health benefits, which are services that all plans must cover. The essential health benefits are:
• ambulatory patient services;
• emergency services;
• hospitalization, such as surgery;
• maternity and newborn care;
• mental health and substance use disorder services, including behavioral health treatment;
• prescription drugs;
• rehabilitative services and devices;
• laboratory services;
• preventive and wellness services and chronic disease management;
• and pediatric services.
“It’s really good insurance,” Sell said. “It’s designed to be similar to a good, large employer plan.”
The law sets income eligibility requirements at 100 percent to 400 percent of the federal poverty level, she said.
Monthly income eligibility requirements for a family/household are:
• one person — $958 to $3,830
• two people — $1,293 to $5,170
• three people — $1,678 to $6,510
• four people — $1,963 to $7,850
• five people — $2,298 to $9,190
• six people — $2,633 to $10,530
• seven people — $2,968 to $11,870
• eight people — $3,303 to $13,210.
More than 10,100 uninsured county residents meet these eligibility requirements, Sell said. More than 1,000 uninsured county residents could purchase Marketplace insurance without tax credits.
Nearly 7,500 uninsured county residents fall below the federal poverty level, she said. They will be unable to obtain insurance without a Medicaid expansion.
State officials have decided to not expand the state’s Medicaid program, TennCare. They recently presented the “Tennessee Plan,” which would cover an estimated 175,000 people, to the U.S. Department of Health and Human Services but haven’t received approval yet.
The state further notified thousands of residents that they will lose coverage under a TennCare-sponsored program that helps small businesses and the self-employed buy health insurance. The limited-benefit plan, CoverTN, doesn’t cover all services required by the Patient Protection and Affordable Care Act and won’t be available after this year.
Under the CoverTN plan, annual benefits were capped at $25,000. Yearly caps aren’t allowed under the federal law.