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Posts Tagged ‘government subsidies’

Who Qualifies for a Government Subsidy?

Monday, September 22nd, 2014

To help make health care more affordable, the federal government offers advance premium tax credits, or subsidies, to low-to middle-income individuals and families. Your subsidy is an advance premium tax credit and is applied directly to your premium. Government subsidies reduce the amount you pay for your insurance plan.

To be eligible for a subsidy, you must meet certain requirements.

  • Be between 100% and 400% of the federal poverty level (FPL).
  • Not eligible for public coverage, such as Medicaid, the Children’s Health Insurance Program,  Medicare or military coverage, such as Tricare.
  • Not have access to minimal essential coverage through an employer. (An exception may be made if your employer’s plan does not cover at least an average of 60% of covered benefits or if the employee’s share of the premium is more than 9.5% of his or her income.  Employers can tell you if their plans meet these criteria.)

Subsidies can be used on any plan you choose except for grandfathered plans and catastrophic plans for those under 30. How much of a subsidy you qualify for is based on income and household size.

Our free BCBSNC Rate Quote offers a calculator to determine if a subsidy may be available to you.

 2016 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA   
Persons in family/household 100% Poverty guideline 250% Poverty guideline 400% Poverty guideline

1

$11,770 $29,425 $47,080

2

$15,930 $39,825

$63,720

3

$20,090 $50,255

$80,360

4

$24,250

$60,625

$97,000

5

$28,410

$71,025

$113,640

6

$32,570 $81,425

$130,280

7

$36,730 $91,825

$146,920

8

$40,890 $102,225

$163,560

For each additional person, add: $4,020 $10,050

$16,080

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For more information on Blue Cross Blue Shield of North Carolina insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888*765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

 

 

 

 

 

 

What Constitutes a Qualifying Life Event?

Monday, September 15th, 2014

bigstockphoto___155599Negotiating new terminology is one of the toughest parts to understanding all the recent changes in health care policies and procedures.  Terms like “open enrollment,” government subsidies,” and “qualifying life event (QLE)” can be confusing even to the most thorough students of health insurance and the Affordable Care Act.  When applying for health coverage, however, understanding these terms and how they can affect your health care options is an absolute imperative.

Under the Affordable Care Act, there are two different periods in which an individual may apply for health insurance.  The first is referred to as Open Enrollment and during this time any person may apply for health coverage.  During Special Enrollment, however, there are more restrictions and a person is required to have what is referred to as a Qualifying Life Event (QLE) in order to acquire health insurance.  If you do not have one of these Qualifying Life Events, you may not purchase health insurance during Special Enrollment and must wait until the Open Enrollment Period.  This is not a Blue Cross Blue Shield of North Carolina policy, but rather a policy of the federal government under the Affordable Care Act with which BCBSNC must comply.

Basically, a Qualifying Life Event is a specific circumstance that has altered your life—and there are strict guidelines to determine exactly what qualifies.  For example, a recent  marriage, divorce or birth of a child are all events that would make you eligible to enroll in health coverage during a Special Enrollment period, so long as you enroll within 60 days of that life altering event.  Losing previously held health insurance involuntarily is another example of a Qualifying Life Event, as is changing your permanent place of residence. If your income increases so that you are no longer eligible for Medicaid, you are also able to enroll in new coverage during a Special Enrollment Period.  Because the list of Qualifying Life Events is so varied, however, it is worth investigating whether you qualify to enroll during a Special Enrollment period.

Although the terminology can be confusing, it is important for you to understand what constitutes a Qualifying Life Event because it can have a huge impact on your ability to purchase health insurance.  In addition, the effective date of your coverage will depend on your QLE and the date of your application.

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). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.