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State officials estimate that more than 640,000 Kentuckians do not have health insurance, and a majority of them are working families.
In LaRue County, 2,334 individuals under 65 do not have health insurance, according to the Governor’s Office.
Starting Oct. 1, many uninsured Kentuckians will be able to sign up for insurance through the Kentucky Health Exchange.
While the individual health exchange will open Oct. 1, the insurance policies will not take effect until Jan. 1, 2014.
The Affordable Care Act also reads that individuals who do not have health insurance could face tax penalties in 2014. That penalty was challenged in court, but it was upheld last year in a 5-4 decision by the U.S. Supreme Court.
Individuals who make up to 138 percent of the federal poverty level ($15,511.50 for a single individual, $31,792.50 for a family of four) may be eligible to sign up for Medicaid coverage. Under the Affordable Care Act, the federal government has agreed to cover the cost of the expanded Medicaid coverage for three years.
About 308,000 Kentuckians will qualify for Medicaid under the expansion, according to Jill Midkiff, director of communications for the Kentucky Cabinet for Health and Family Services, which oversees the exchange.
In LaRue County, 1,112 residents will qualify for the expanded Medicaid coverage, according to the Governor’s Office information.
Individuals who earn up to 400 percent of the federal poverty level will be eligible for subsidies to assist with the cost of their premiums. State officials estimate that 276,000 Kentuckians will qualify for a subsidy, including 1,041 LaRue County residents.
Midkiff noted that signing up for Medicaid or a private health insurance policy through the exchange will not affect children’s eligibility for the Kentucky Children’s Insurance Program.
To date, the Cabinet for Health and Family Services has received $252 million in grants from the Federal Department of Health and Human Services to help set up the exchange, according to Midkiff.
With the exception of Medicaid (which has its own requirements for eligibility), all of the plans offered through the exchange will be from private companies, according to Midkiff.
She added that anyone who has insurance through his or her employer will be able to keep that insurance. They will not need to purchase insurance through kynect.ky.gov, she wrote.
She pointed out that with many employer-based insurance plans, premium costs are deducted from the employees’ paychecks, and in most cases the employer pays at least a portion of those premiums.
Midkiff added that individuals who sign up for insurance through the exchange will need to make monthly payments to the insurance provider. The first payment will be due 15 days before coverage begins.
To access the exchange, individuals will need to visit its website, kynect.ky.gov.
Jack Tillman of Kentucky Health Cooperative (a non-profit insurance company) described the exchange as being similar to Travelocity for health insurance, when he spoke in Marion County in June.
Individuals who need assistance navigating the website can call 1-855-4kynect. The state also is training “kynectors,” who can help individuals and small businesses assess their health plan needs, according to Midkiff.
At kynect.ky.gov, visitors will be able to compare policies from private companies. Under the Affordable Care Act, every policy offered must include coverage for ambulatory patient services, emergency services, maternity and newborn care, pediatric services (including dental and vision), rehabilitative services and devices, mental health, preventive and wellness services, hospitalization, prescription drugs, and laboratory services.
Bronze, silver, gold and platinum plans will be offered.
“As the metal level increases in value, so does the percentage of medical expenses that a plan will cover,” Midkiff wrote in an email. “This means that the platinum level plan will cover the highest portion of medical costs at the time of care. It will also have the highest premium cost.”
In order to sign up for a plan, individuals will need to provide their Social Security number (to verify their citizenship) and information about their income (to determine if they are eligible for subsidies to offset some premium costs). Midkiff added that some additional information may be required if the system is not able to verify their identity or income. She also noted that state officials have kept privacy and security concerns in mind while developing the exchange.
“Rigorous standards and requirements for safeguarding information have been developed, both in terms of technology and in expectations for employees, application counselors, and others who may help individuals apply for coverage,” Midkiff wrote.
Calculating insurance premiums
The Henry J. Kaisar Family Foundation has created an online calculator to help people understand how much they may pay for health insurance under the Affordable Care Act.
According to the calculator, a single, 30-year-old non-smoker making $30,000 per year would be looking at a premium of $3,018 annually. However, that person would be eligible for a $507 subsidy, which could reduce his or her premium payments to $2,512 per year.
A family of four making $45,000 per year would be looking at annual premiums of $9,869. They could receive a subsidy of $2,650, which would reduce their premium costs to $7,219 per year.
A single parent with one child making $25,000 would face annual premiums up to $4,935. This parent may qualify for a subsidy up to $1,129, which would reduce his or her annual premium to $3,806.
To access the tool, follow this link: http://goo.gl/X8uJ2B.
For more information about the Kentucky Health Exchange, go to kynect.ky.gov.
Editor Linda Ireland contributed to this story.