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Affordable Health Insurance

The Affordable Care Act
The Affordable Care Act (ACA) requires everyone legally living in the U.S. to have health insurance. It gives millions of individuals with too little, or no insurance, access to health plans at different cost levels. The law also provides financial assistance to those who qualify based on family size and income.

The Health Insurance Marketplace, also known as an “Exchange,” allows individuals and families to shop for a plan that fits their budget and coverage needs. By law, under the Affordable Care Act, most people over age 18 must have health insurance or face tax penaltiesIf you have Medicaid or Medicare coverage, that meets the requirement.

What Do the Plans Cover?
Benefits include doctor visits, hospital stays, wellness care, prescriptions, emergency services, maternal and newborn care, pediatric care and more.

In fact, Ten Essential Health Benefits must be covered in every plan and certain Preventive Care Services will be provided at NO additional cost to patients. Also, patients cannot be turned away due to pre-existing conditions, as has been the case in the past.

Maryland Health Connection
For Maryland residents, Maryland Health Connection is the one-stop-shop to easily compare plans based on benefits and cost. Open enrollment has ended for 2014. The next enrollment period begins in Fall 2014 for coverage beginning in January 2015. To learn your options until the next enrollment period begins, visit www.marylandhealthconnection.gov or www.healthcare.gov.

Whether you’re currently uninsured, you’ve been denied coverage in the past, or you just want to explore new options, Maryland Health Connection gives you more choice and control over your health coverage.

Financial Assistance
A surprisingly large number of people may qualify for financial help through the Affordable Care Act. For example, an individual earning up to $45,960 a year, or a family of four earning up to $94,200 a year, will qualify for a reduction of their monthly premiums, or a tax credit at the end of the year. The chart on this page gives you a good idea of how much assistance will be available. Once you apply at the Marketplace during open enrollment, which begins Fall 2014, you will find out the exact amount.

 

 
If your household size is this:

 
You may be eligible for Medicaid if your income* is this:

 
You may be eligible for reduced premiums and/or lower insurance costs if your income is this:

 

1

 

Less than $15,856

 

$15,857 – $45,960

 

2

 

Less than $21,404

 

$21,405 – $62,040

 

3

 

Less than $26,951

 

$26,952 – $78,120

 

4

 

Less than $32,499

 

$32,500 – $94,200

 

5

 

Less than $38,047

 

$38,048 – $110,280

 

6

 

Less than $43,595

 

$43,596 – $126,360

 

7

 

Less than $49,143

 

$49,144 – $142,400

 

8

 

Less than $54,691

 

$54,692 – $158,520

Source: Maryland State Department of Health and Mental Hygiene, Medicaid Planning Administration

*Income eligibility levels for children and pregnant women are higher

 

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