The Affordable Care Act (ACA) was enacted in 2010 and states began to create exchanges or marketplaces for health insurance. MNsure is Minnesota’s marketplace. It is a website that allows you to browse and purchase health insurance plans for your particular needs.
MNsure offers plans and provider networks from the following four companies:
- Blue Cross Blue Shield of Minnesota
- UCare Minnesota
All plans must cover the following essential services:
- doctor visits
- emergency care
- in-patient hospital services
- maternity care
- newborn care
- mental healthcare
- substance abuse rehab services
- rehabilitative care (includes speech, occupational, or physical therapy)
- habilitative services and devices
- laboratory services
- chronic disease management
- pediatric care
There are four basic plans available through the exchange. These have varying coverage levels. They include:
- bronze (60 percent of expenses paid)
- silver (70 percent)
- gold (80 percent)
- platinum (90 percent)
Lower plans have lower premiums, but higher out-of-pocket costs. A catastrophic plan with a high deductible is available for those under the age of 30.
Many people will want to know how much of a subsidy they qualify for, but the real question is, how much will you pay? Your ultimate decision should be based on your income versus how often you might need to use the coverage. For example, if your annual income is $32,500 (273 percent of the poverty level), the most you’ll have to pay for health insurance is 9 percent of your income. This amounts to $2,592 a year, or $216 a month.
A silver plan for a 40-year-old non-smoker is estimated to cost up to $282 per month in Minnesota, depending on the region. There are nine different regions in Minnesota.
A helpful calculator offered by the Kaiser Family Foundation provides an estimate of your subsidy eligibility and how much you should expect to spend on health insurance.
Depending on your income, you may qualify for financial aid to help offset the costs of coverage. This may come in the form of:
- Medicaid coverage
- tax credits
Adults living at or below 200 percent of the federal poverty level (FPL) may qualify for Medicaid in Minnesota. Pregnant women living at or below 278 percent of the FPL may also qualify. According to the Health Insurance Marketplace, the FPL for 2015 is:
- $11,770 in individual annual wages
- $15,930 for those in families of two
- $24,250 for a family of four
- $40,890 for a family of eight
As of 2015, the annual maximum out of pocket is $6,600 for individuals and $13,200 for families. Capping out-of-pocket costs will help consumers pay medical bills that aren’t covered by insurance, reducing your chances of bankruptcy.
Tax credits are based on the silver plan. This helps you determine any extra out-of-pocket costs if you choose a higher or lower plan. The ACA was designed so the silver plan is more affordable for individuals buying their own insurance. This is regardless of how expensive the healthcare rates are where you live.
To learn more about MNsure, please visit http://www.mnsure.org. You can also call 1-855-3-MNSURE (1-855-366-7873).
Open enrollment for MNsure starts November 1, 2015, and ends January 31, 2016.
Do your research before the open enrollment period to ensure you know what coverage plan is best for you and your family.