Health InsuranceAnnual Open Enrollment Periods

Medicare* – Oct 15th to Dec 7th

Obamacare*# - Nov 15th to Feb 15th

Medicaid Expansion # – starts Dec 1st

*Special enrollments periods exist #Based on income and household size

Last year, 150,000 Obamacare health policies

Almost 100,000 newly

eligible individuals for health insurance

Examples of the uninsured?

Daycare workers Food service workers Barbers Beauticians Taxi drivers Part time workers Young adults Unemployed individuals Small business

owners/employees

Household Size

MedicaidExpansion

1 < $619 $619 $1,007 $1,795 > $1,795

2 < $835 $835 $1,512 $2,420 > $2,420

3 < $1,043 $1,043 $1,903 $3,044 > $3,044

4 < $1,266 $1,266 $2,293 $3,669 > $3,669

Obamacare Marketplace

Situation?Bi-Weekly Gross Pay

Household Size

MedicaidExpansion

1 < $16,105 $16,105 $29,175 $46,680 > $46,680

2 < $21,707 $21,707 $39,325 $62,920 > $62,920

3 < $27,310 $27,310 $49,475 $79,160 > $79,160

4 < $32, 913 $32,913 $59,625 $95,400 > $95,400

Obamacare Marketplace

Situation?Annual Income

6

Health Plan CategoriesHealth Plan Categories

Highest PremiumsLowest Out-of-Pocket Costs

Lowest PremiumsHighest Out-of-Pocket Costs

Covered Percent of Total Cost of Care Covered 60% 70% 80% 90%

7Health Insurance Marketplace 101

6/20/13

Ambulatory patient services Prescription drugsEmergency services Rehabilitative and habilitative

services and devicesHospitalization Laboratory servicesMaternity and newborn care Preventive and wellness services

and chronic disease management

Mental health and substance use disorder services, including behavioral health treatment

Pediatric services, including oral and vision care (pediatric oral services may be provided by stand-alone plan)

Qualified Health Plans cover Essential HealthBenefits which include at least these 10 categories

Essential Health BenefitsEssential Health Benefits

“Obamacare” Marketplace (some will get a federal “coupons”)

(State approval + Federal dollars =) Medicaid Expansion

Options for the Uninsured

Enrollment options

Health InsuranceSign up Options

Medicaid Expansion – www.compass.state.pa.us or 1-866-550-4355 (Starts December 1st)

Special enrollments periods exist*

Obamacare Marketplace – www.healthcare.gov or 1-800-318-2596

Enrollment options

• Stay tuned for more in-person assistance enrollment options

Visit www.bhnphilly.org for more info

Key points New health insurance options for

EVERYONE. Most people DO NOT know. People MUST ACT

To get coverage To potentially get a better deal or save

money Help is available