Health Care Marketplaces and insurance plans for individuals

The Affordable Care Act will provide different levels of insurance coverage, but will assure individuals receive a core of 10 essential services.

Over the last three years we have been hearing about the Affordable Care Act, which the federal government enacted on March 23, 2010 and the Supreme Court upheld on June 28, 2012. What does that mean for an individual who does not yet have health insurance coverage? Individuals will be required to have health care coverage starting in 2014, or face a health care tax. Consumers will be buying health care coverage through online marketplaces. But what type of plans will be available to purchase?

Each state will be offering four levels of coverage; a bronze, silver, gold or platinum level. Plans will be defined in each level. All plans offered to individuals will include 10 core health benefits which include hospitalization, prescription drugs, mental health, rehabilitation care and preventive services. These types of services are typically seen in employer based plans according to the U.S. Department of Health and Human Services.

Premiums will be based upon an individual’s or family’s level of income. The April 2013 AARP bulleting said that single people with an income up to $45,960 and couples with an income up to $62,040 may be eligible for tax credits. The exact income levels for 2014 have not yet been set. The tax credit is figured in when you register for a health plan. The amount of the tax credit is sent directly to the insurance company and applied to your premium costs. This lowers your actual out of pocket cost for the premium.

The accessibility of comprehensive coverage will be an advantage to individuals and families who have preexisting conditions, which in the past have disqualified them from various plans. In addition, it will make health care coverage more affordable for the average family or individual. The new system also allows the flexibility of deciding whether to be self-employed, retire early, or change jobs without worrying about being dropped from a group plan and not qualifying for an individual plan. If an individual decides not to purchase a plan in 2014, they will pay a tax of $95 or up to one percent of their income, whichever is greater. In 2016 the tax will rise to $695 or 2.5 percent of their income. For more information on the levels of insurance offered and plans go to

For questions about health insurance and the Affordable Care Act, contact your local Michigan State University Extension office, which are located in 82 counties across the state of Michigan.

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