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  • My eligibility for Medicaid depends on how my income compares to 138 percent of the Federal Poverty Level. Can you spell out what that means in dollars? November 16, 2017 11:59 am
    Q. I know that whether I qualify for expanded ­Medicaid depends on how my income compares with 138 percent of the Federal Poverty Level (FPL). I also understand if I earn too much to qualify for Medicaid, I can buy insurance in the exchange, where I may be eligible for subsidies, again depending on how my income compares to the FPL. Can you spell out what that means in dollars? A. First, in states that have expanded Medicaid you will qualify for Medicaid if you earn less than 138 percent of the FPL. For a single individual in 2016, the upper income limit for Medicaid eligibility is $16,394, and for a family of four, the upper income limit is $33,534.
    Michael Rickard
  • Virginia health insurance marketplace: history and news of the state’s exchange November 16, 2017 1:11 am
    Seven insurers are offering exchange coverage in Virginia for 2018. But rates will be sharply higher in 2018, and many enrollees will have to pick different plans, as there are some insurer exits and coverage area changes. Average rate increases for 2018 vary from 35 to 81 percent, with insurers assuming that CSRs will not be funded in 2018. The bulk of the rate increases are on silver plans, and will be offset by premium subsidies for most enrollees.
    Michael Rickard
  • How long can I be uninsured before I have to pay the individual mandate penalty? November 15, 2017 6:54 am
    Q. I know that the individual mandate allows for a gap in coverage as long as it's less than three months in a year. But what if I have two gaps that are each just a month long? Or what if I'm uninsured for the last two months of one year and also the first two months of the following year? A. It applies only to the first short gap in coverage during the year. The gap in coverage has to be less than three months in duration. If you're uninsured for three or more months, you'll pay a penalty for the full duration of the gap (including the first two months) If you're insured for even a single day of a given month, you're considered insured for that month. It's very unlikely that you'll be able to obtain a health insurance plan with a start date of anything other than the first of the month, or that you'll be able to terminate a plan on anything other than the last day of a month. The IRS has addressed the possibility of a gap in coverage that spans two calendar years.
    Michael Rickard
  • Maryland health insurance marketplace: history and news of the state’s exchange November 14, 2017 9:23 am
    Evergreen Health, an ACA-created CO-OP, is not selling or renewing individual market plans for 2017. They had filed rates to re-enter the individual market in 2018, including the exchange, but that fell through when the investors who had planned to acquire them backed out, and the CO-OP is now in receivership. CareFirst, Cigna, and Kaiser also filed rates to offer plans in the exchange in 2018, although Cigna later withdrew their filings. CareFirst, CareFirst Blue Choice, and Kaiser plan to offer exchange plans for 2018, and the cost of CSR has been added to on-exchange silver plan premiums only.
    Michael Rickard
  • Will you owe a penalty under Obamacare? November 14, 2017 8:30 am
    If you decide not to purchase coverage and remain uninsured, you can use the calculator on this page to determine the size of the penalty you would pay. But here's the good news: many uninsured Americans are exempt from the penalty, and premium subsidies are making health insurance affordable - often for the first time - for millions of people.
    Michael Rickard
  • New Jersey health insurance marketplace: history and news of the state’s exchange November 12, 2017 10:05 am
    Three carriers are offering plans in the exchange for 2017, although two are entities of AmeriHealth. For 2018, Oscar is rejoining the exchange, after exiting at the end of 2016. Oscar plans are available in 14 counties for 2018.
    Michael Rickard
  • Iowa health insurance marketplace: history and news of the state’s exchange November 12, 2017 8:48 am
    Four carriers are offering plans in the Iowa exchange in 2017. But Wellmark, Aetna, and Gunderson are leaving the ACA-compliant individual market at the end of 2017. Medica has filed plans to remain, but with a 57 percent rate increase. As an emergency measure, Iowa has proposed a unique 1332 waiver, and is optimistic that CMS will approve it.
    Michael Rickard
  • Nevada health insurance marketplace: history and news of the state’s exchange November 12, 2017 8:23 am
    Nevada was one of only nine states on the HealthCare.gov platform with single-digit average benchmark premium increases for 2017, and enrollment grew slightly for 2017, in contrast to the average enrollment decline across all HealthCare.gov states. Silver Summit (Centene) has joined the exchange for 2018, but Prominence and Anthem are leaving the exchange.
    Michael Rickard
  • Wisconsin health insurance marketplace: history and news of the state’s exchange November 12, 2017 8:02 am
    Wisconsin's exchange remains among the most robust in the country. Of the 14 insurers that offered coverage for 2017, all but three are continuing to offer coverage for 2018. Anthem, Molina, and Health Traditions are leaving the exchange at the end of 2017, and do not have plans available during open enrollment. Rates are sharply higher for 2018 (due in large part to the elimination of federal funding for cost-sharing reductions) but premium subsidies will offset the rate hikes for most enrollees.
    Michael Rickard
  • Hawaii health insurance marketplace: history and news of the state’s exchange November 11, 2017 8:17 am
    Starting in November 2016, to facilitate enrollment in plans for 2017, Hawaii switched to a fully-federally-run exchange. In December 2016, CMS approved Hawaii's 1332 waiver proposal to eliminate the SHOP exchange as of January 2017. The waiver is approved for five years, and money CMS would have spent on SHOP tax credits will instead be sent to Hawaii for use in implementing the 1332 waiver, including their Premium Supplementation Program. Hawaii enacted a bill in 2017 that allows pharmacists to prescribe and dispense up to 12 months of contraceptives. And for 2018, insurers are assuming that CSR funding will not continue, and are adding the extra cost to on-exchange silver plans.
    Michael Rickard
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