Overview of Minnesota’s Health Insurance Exchange
When the Affordable Care Act was passed in 2010, states gained the opportunity to build health insurance marketplaces, called exchanges. MNsure is Minnesota’s marketplace. The site allows you to find health plans from multiple insurers and can help you determine which plans best fit your particular needs.
MNsure is offering 141 plans from the following key providers: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, PreferredOne Insurance Company, and UCare Minnesota.
Individuals, families and small businesses can begin shopping and comparing rates on October 1, 2013, by visiting mnsure.org. They can also reach out to one of MNsure’s community partners or MNsure-certified agents/brokers to secure health insurance through MNsure.
Open enrollment lasts until March 1, 2014. Your plan will be effective on January 1, 2014.
Comparison of plans will be easily available to consumers who visit mnsure.org after October 1, 2013. They will be able to see plans side-by-side and choose the plans that are right for them and their families.
Per the Affordable Care Act all plans must offer the following essential services:
- Ambulatory patient services (doctor visits)
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices (Habilitative services are for people with disabilities who need speech, occupational, or physical therapy.)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Mental health and prescription coverage will be offered through all plans. Some plans will also offer dental coverage, and individuals can also buy separate dental-only plans through MNsure.
There are four basic plans available with varying levels of coverage: Bronze (60 percent of expenses paid by plan), Silver (70 percent), Gold (80 percent), and Platinum (90 percent). Lower plans have lower premiums, but higher out-of-pocket costs. A catastrophic plan is available for folks under the age of 30. This plan has a high deductible.
Adults living at or below 200 percent of the federal poverty level (also known as FPL, which is $11,490 a year in wages for one person and $23,550 a year in wages for a family of four), or pregnant women living at or below 278 percent of the FPL, can qualify for Medicaid in Minnesota, based on eligibility requirements that take effect January 1, 2014.
Additional federal financial protection provisions start in 2015 that include a maximum annual out-of-pocket cost of $6,350 for individuals and $12,700 for families. Capping out-of-pocket costs will help consumers pay medical bills that aren’t covered by insurance, reducing the chances of bankruptcy.
Tax credits are based on the Silver Plan, so you can easily determine what your additional out-of-pocket costs will be if you elect a higher or lower plan compared to the Silver. The Affordable Care Act (ACA) was designed so the Silver Plan would be affordable to people who had to buy their own insurance, regardless of how expensive the healthcare rates may be where they live.
A Silver Plan for a 40-year-old non-smoker ranges from $154 to $326 per month in Minnesota, depending on the region. There are nine different regions. The average premium on a Silver Plan for a 40-year-old non-smoker is $217.35. See the Approved and Effective Rate Filings page on the Minnesota Department of Commerce's Insurance site for full rate data for all the insurance plans offered via MNsure. Individuals and families with incomes under 400 percent of the federal poverty level, and who are covered by an exchange plan, are eligible for healthcare tax credits that can be used to offset insurance premiums. The payment of credits will begin in 2014.
People want to how much their subsidies are, but the real question is how much will you pay? Once you figure out what the maximum healthcare percentage is for your income, then you know that's the most you'll have to pay for a Silver Plan (you may pay less). For example, if your annual income is $32,500 (283 percent of the poverty level) the most you’ll have to pay for health insurance is nine percent of your income. This amounts to $2,926 a year, or $244 a month. The challenge is to look at the costs of Bronze, Silver, Gold, and Platinum, and decide which plan offers the best value for you. Here is a calculator offered by the Kaiser Family Foundation that provides an estimate of your subsidy eligibility and how much you should expect to spend on health insurance.
Information on Subsidies
People who qualify for Medical Assistance, tax credits, payment assistance, or MinnesotaCare are as follows:
- Children and pregnant women under 275 percent of the federal poverty level qualify for medical assistance.
- Individual people with incomes up to $15,282 qualify for medical assistance.
- People with incomes between $15,282 and $22,980 qualify for MinnesotaCare.
- Having an income of $22,981 and $45,960 qualifies you for tax credits, which help lower premiums.
To learn more about MNsure, please visit http://www.mnsure.org or call 1-855-3-MNSURE (1-855-366-7873).