Batesville Herald Tribune, Batesville, Indiana

Opinion

January 7, 2014

New healthcare law requires consumer education

(Continued)

Unfortunately, while some consumers may financially benefit through tax credits, insurance through the federal marketplace is subject to burdensome regulations, like limits on the premium discounts people can receive for maintaining good health. These regulations mean that many middle-class healthy Hoosiers will pay higher premiums than they do now – even if they buy insurance through the federal marketplace and receive tax credits to help cover costs.

When it comes to individuals shopping on the exchange, the costs vary widely depending on these variables: income, age and where one lives. In general, lower-income individuals and people in poor health will be able to pay less out of pocket for insurance than it currently costs because of federal tax credits.

Indiana residents should also note insurance companies are allowed to charge tobacco users up to 50 percent more than non-tobacco users, although the enforcement process is unknown.

What are the options?

For those in my district considering enrolling in the exchange, provider and hospital choices are extremely limited. Six out of seven counties in my district are limited to Anthem coverage only. Shelby county residents are eligible to receive either Anthem or MDwise coverage.

For most people, there are four levels from which to choose. Few people will qualify for a $0 payment option: Bronze Plan: You pay 40 percent and the plan pays 60 percent; Silver Plan: You pay 30 percent and the plan pays 70 percent; Gold Plan: You pay 20 percent and the plan pays 80 percent; Platinum Plan: You pay 10 percent and the plan pays 90 percent.

In addition, the deductibles and out-of-pocket maximums vary based on the plan selected and the state where an individual resides. For example, the out-of-pocket maximum for a bronze plan is $6,350 in Indiana, but the out-of-pocket maximum for a silver plan is also $6,350 in Tennessee. I strongly urge you to review the deductibles and out-of-pocket expenses by researching on www.healthcare.gov and selecting “Indiana.”

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