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How do Subsidies like Cost-Sharing Reductions Work?

Monday, September 9th, 2013

Cost-Sharing Reductions are only available to those who qualify. Again, they do not apply to Grandfathered Plans. If you qualify, you will want to take advantage of both Cost-Sharing Reductions and Advanced Premium Tax Credits. You can use them both to maximize your savings.Cost-Sharing Reductions are only available to individuals who are ineligible for public coverage and are unable to get qualified health insurance through an employer.

COST-SHARING REDUCTIONS:

2014 plans will be grouped into four metallic levels: Bronze, Silver, Gold and Platinum. In order to take advantage of Cost-Sharing Reductions, you must choose a Silver plan. They help lower out-of-pocket expenses, such as deductibles, co-pays and coinsurance.

Cost-Sharing Reductions are only available for households with incomes thatare between 100% and 250% of the Federal Poverty Level (FPL).

For example, let’s say you go to the doctor and are charged $100. Normally with a Silver plan you might have a co-pay of $25, but because
you qualify for Cost-Sharing Reductions and you chose a Silver plan, you may have a co-pay as low as $5.

Cost-Sharing Reductions can also lower deductibles. For example, a $3,500 deductible may be lowered to $500.

With Cost-Sharing Reductions, you essentially pay for a Silver plan but receive the richer coverage of higher metallic level plans, thereby reducing your out-of-pocket expenses. If you qualify for Cost-Sharing Reductions, you should take advantage of this cost savings benefit.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Information from a BCBSNC publication on 8/12/13.

How do Advanced Premium Tax Credits Work?

Friday, September 6th, 2013

There are two types of federal subsidies to help reduce health care costs in 2014.They are Advanced Premium Tax Credits and Cost-Sharing Reductions.

+ Advanced Premium Tax Credits lower your monthly premium.

+ Cost-Sharing Reductions help lower out-of-pocket expenses including deductibles, co-pays and coinsurance at the place of service, like doctor and hospital visits. Subsidies are only available on new 2014 plans for those who qualify. Subsidies cannot be applied to Grandfathered Plans, but it may be worth it to switch.

+ Advanced Premium Tax Credits are only available to individuals who are ineligible for public coverage and are unable to get qualified health insurance through an employer.

+ Advanced Premium Tax Credits are determined by income and family size in relation to established Federal Poverty Levels (FPL). Many Americans will qualify for Advanced Premium Tax Credits, including the middle class. Those that qualify must have a household income between 100% and 400% of FPL for their family size.

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