With many people curious about how the new law impacts this situation, we wanted to high light an age group we know does very well under the new law. Those who are 50 years old or older often do well under the new law.
If you have:
- No access to group coverage through your employer or spouse’s employer
- Income between $16,000 to $60,000
The new changes will work in your favor. Here is a real life example:
John, 63, is a semi retired self employed handy man. He works when he wants and has an income of $14,000 a year. His income will make him eligible for the subsidy and cost share reductions. His coverage under ACA with the subsidy and cost share reduction includes the following:
· Monthly subsidy of $594
· Silver Enhance plan (this offers cost sharing reductions to the silver plan). Total plan cost was $599.25. With the subsidy the monthly premium he is responsible for is $5.25/month
· Plan Benefits are as follow:
o $500 individual deductible
o $700 out of pocket maximum
o $5 primary copay
o $10 specialist copay
o $15 urgent care copay
o $100 ER copay
o RX copays of $10, $25, $50, $70, or 25%
As the above shows, John is able to obtain the health coverage he needs at a premium anyone can afford. His previous $200 per month premium plan had less benefits and more out of pocket exposure. John’s case is not a unique or sensationalized case. We have many people who have enrolled into plans will very low premiums. Plans premiums are simply a factor of your income, household size, geographical location in NC, and if you smoke or not. These determine if you qualify for a subsidy and/or cost share reduction. If you are not sure about your situation, complete the form on the right and we will contact you by phone for a quick 5 minute review.
Here are some common questions we receive from people we help.
Will you charge me to help me enroll? Will I pay more to use you?
No, we are compensated by the carrier you choose. The price is the same if you go through the exchange by yourself or with us. However, we have enrolled hundreds of people so far. We are very experienced with the system and know what works and what causes it to give errors. We learned the hard way so you won’t have to.
Why use you? Why not use a navigator or call the 800 number?
Again, there is no cost to use our services. You get our 16 years of insurance experience at no cost to you. We are contracted with both carriers and certified to write coverage on the Marketplace. We help you understand how the plans work and show you some of the holes in coverages that you need to be aware of. Navigators have no idea what the networks are or where the holes in coverage are because they aren’t licensed with each carrier.
How do you help me?
From the comfort of your own home, we take the time to “hold your hand” through the entire process. We walk you step by step through the system over the phone or online. From subsidy eligibility, plan review, enrollment, and covering what you will need to do after enrollment.
I hope we have shown you the value of working with us as compared to calling the website or working with a Navigator. Why not give us a try to see how we can help you enroll. Either Kent or Rusty will be happy to help you!