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Your Health, Your Choice: The Affordable Care Act - April 18 Live Chat Event

Join us from noon to 1pm on Friday, April 18, as an expert panel answers your questions about the Affordable Care Act. If you'd like to ask a question before the Live Chat Event begins, please click on "Make A Comment" and submit it below!

  • How does this work for people who are way below guidelines for poverty? How does the government pay for poor peoples insurance? Please answer directly, clearly and in English and in "laymans terms"that we can all understand.
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  • As an optician, we have heard no reliable answer as how "pseudo" medical as I call it is going to be insured; dental, vision, chiropractor, etc. Is it going to be like Medicaid that considers yearly vision screenings a necessary component to good health and has basic coverages built in? Or will it be like Medicare that only covers "medically-necessary" procedures and not routine ones like yearly eye exams and thus has limited to no coverage? Or will it be like the supplemental that are available and if you want vision coverage you will have to pay for it? Even the legislators don't seem to know and pushing everything further and further down the line is not allowing anyone to prepare.
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  • I'm one of three owners of a small family business. For the last twenty years we have been able to offer our 24 to 30 employees full family health insurance. Can you tell me why our insurance premiums are increasing 83% from last year? Our current insurance is with Highmark and is up for renewal. How is the affordable care act helping small businesses? We our now being forced to go with a 5,000.00 per person deductible and 10,000.00 per family deductible. The plan we are being forced to leave do to the 83% increase was 1,000.00 person and 2,000.00 family. By going with these extremely high deductibles we are still looking at a premium increase from last year. Please explain.
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  • First off as of Feburary 2013 my husbands employer drop me off there health insurance because I was the spouse of his employee. Since then I have been trying to get health insurance and the cost is been quoted to me of $350.00 to $420.00 a month witch I can not afford! I am 63 years old and up until last Feburary always had health insurance, but now I am at a loss. How am I to have health insurance when it is not affordable? i am a diabetic 2,sleep apnea and since november2013 I have not been able to take my medication I need and supplies for my c-pat. I am starting to think that the government would like to have us baby boomers die early so they can have our social security money. I am so disappointed and scared. I hope that you may have information to help me.
    by Judy Stough edited by abc27 Live Chat 4/18/2014 12:34:44 PM
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  • Will my premiums go up next year when I have to renew?
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  • Welcome to the final "Your Health Your Choice" Live Chat Event! Our experts are here to answer your questions!
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  • Many People are struggling with the fact they didn't qualify for a tax credit due to low income and cannot afford the health insurance. Here are the qualifiers for exemptions from the penalty:
    Most people must have health coverage or pay a fee (the “individual shared responsibility payment”). You can get an exemption in certain cases.

    The individual shared responsibility payment
    If you can afford health insurance but choose not to buy it, you must pay a fee known as the individual shared responsibility payment.

    The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it's 2.5% of income or $695 per person, whichever is higher.

    If you're paying under the $95 per person method, in 2014 the payment for uninsured children is $47.50 per child. The most a family would have to pay under this method in 2014 is $285.

    You make the payment when you file your 2014 taxes, which are due in April 2015.

    Exemptions from the payment
    Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”
    Many People are struggling with the fact they didn't qualify for a tax credit due to low income and cannot afford the health insurance. Here are the qualifiers for exemptions from the penalty:
    You may qualify for an exemption if:

    •You’re uninsured for less than 3 months of the year
    •The lowest-priced coverage available to you would cost more than 8% of your household income
    •You don’t have to file a tax return because your income is too low (Learn about the filing limit.)
    •You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
    •You’re a member of a recognized health care sharing ministry
    •You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
    •You’re incarcerated, and not awaiting the disposition of charges against you
    •You’re not lawfully present in the U.S.
    Hardship exemptions
    If you have any of the circumstances below that affect your ability to purchase health insurance coverage, you may qualify for a “hardship” exemption:

    1.You were homeless.
    2.You were evicted in the past 6 months or were facing eviction or foreclosure.
    3.You received a shut-off notice from a utility company.
    4.You recently experienced domestic violence.
    5.You recently experienced the death of a close family member.
    6.You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
    7.You filed for bankruptcy in the last 6 months.
    8.You had medical expenses you couldn’t pay in the last 24 months.
    9.You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
    10.You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
    11.As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
    12.You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.
    13.Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable.
    14.You experienced another hardship in obtaining health insurance.
    How to apply for an exemption
    If you're applying for an exemption based on: coverage being unaffordable; membership in a health care sharing ministry; membership in a federally-recognized tribe; or being incarcerated:

    You have 2 options:

    1.You can claim these exemptions when you fill out your 2014 federal tax return, which is due in April 2015
    2.You can apply for the exemptions using the right form below. See instructions to help you fill out an exemption application.
    •Form to apply for exemption based on coverage being unaffordable (if you live in a state using Healthcare.gov)
    •Form to apply for exemption based on coverage being unaffordable (if you live in a state using its own health exchange)
    •Form to apply for exemption based on membership in a health care sharing ministry
    •Form to apply for exemption for American Indians and Alaska Natives and others who are eligible for services from an Indian health care provider
    •Form to apply for exemption based on being incarcerated
    Note: If you get an exemption because coverage is unaffordable based on your expected income, you may also qualify to buy catastrophic coverage through the Marketplace. This may be more affordable than your other options.

    If you’re applying for an exemption based on: membership in a recognized religious sect whose members object to insurance; eligibility for services through an Indian health care provider; or one of the hardships described above:

    •You fill out an exemption application using the right form below. See instructions to help you fill out an exemption application.

    •Form to apply for exemption based on membership in a recognized religious sect whose members object to insurance
    •Form to apply for exemption based eligibility for services through an Indian health care provider
    •Form to apply for exemption based on a hardship
    If your income will be low enough that you will not be required to file taxes:

    •You don’t need to apply for an exemption. This is true even if you file a return in order to get a refund of money withheld from your paycheck. You won’t have to make the shared responsibility payment.
    If you have a gap in coverage of less than 3 months, or you're not lawfully present in the U.S.:

    •You don’t need to apply for an exemption. This will be handled when you file your federal tax return.
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  • is a link to the tool on the PA Community Health Center site which would allow you to locate a local community health center which do offer healthcare services on a sliding scale based on income. This does not address obtaining health insurance but being able to receive services at a reduced cost or even possibly free may be the next best thing for some individuals. If you can not obtain affordable coverage I look into this along with looking for exemptions that you could qualify for to avoid paying the individual mandate costs for not having insurance.
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  • What is the penalty if someone doesn't obtain health insurance. I am a fulltime college student and my only income is work study. I looked online and the cheapest insurance was $69 a month. There will be many months I will not be able to pay for it.
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  • does Obamacare replace CHIP in PA
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  • How will I prove my income to be able to qualify next year? Is there anything I can do in the tax year for 2014?
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  • if you are below 100% poverty level you are out of luck. no insurance option for the working poor! family of 3 making less than $19,530 get no subsidy! its absurd. thanks to corbett. may as well quit your job and collect welfare!
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  • I'm on Medicare. Is there anything I need to do for the new health care law?
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  • why, when you went on the healthcare.gov site to review prices/plans... it had my husband and i showing we would pay $11 a month. but when i called healthcare.gov they quoted us at $66 a month? i was so excited to be able to get healthcare... only to find we can not afford to purchase it. thanks!
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  • My family does not have insurance now, but if am now eligible for coverage with my employer. The down side is that I can't afford the insurance premiums quoted on the healthcare website. Will we be fined for not having coverage?
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  • What if someone is unemployed and have no income what so ever. How does a person pay for something when they have no money??
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  • I have questions for coverage for my 22 yr old daughter who is currently unemployed. She received her associates last yr and wants to attend college this fall but does not drive and the college is not local. She lives with us but I am just now returning to work due to being home with my 12yr old special needs child the past couple of yrs. my coverage is very expensive and I would not be bringing home much of anything if I add her but she also does not qualify for the medicaid coverage. Do you have any suggestions?
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  • I am a 28 year old male who has returned to college. I will graduate in December 2014. I am unemployed and go to school full time with student aid. I live with my parents but I am too old to go on their health insurance. I am single with no children. How am I suppose to pay for a insurance premium?
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  • We are 63 and want to retire in July. We plan to live off of pension and savings until Medicare kicks in. What do we consider as income for ACA and subsidies??
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  • Why can't I get help with paying for insurance when I don't qualify for Medical assistance and I don't make enough money for help with Obamacare. So I have to go without insurance.
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  • I am on short term disability due to shoulder replacement surgery. My surgeon said I would be off work approximately 15 weeks for recovery but my employer says they will be cancelling my health insurance at 12 weeks. What do I do.
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  • Since Pa did not expand medicaid which is what I qualify, do I still need to enroll? I am childless and over 50. Also does medicaid upon death go after whatever assets are available in my estate for repayment??
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  • When I qualify for insurance through my employer can I terminate my coverage through Obamacare/marketplace?
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Untitled Document McClain
Deb McClain
Commercial Account Manager/Investment Consultant, Members 1st Insurance Services
Deb McClain comes to Members 1st Insurance Services with 33 years of experience. She is licensed in Property, Casualty, Life, Accident, Health, Fixed and Variable Annuities. Her vast experience enables her to serve members and clients with their best interest in mind.



Lausch
Ben Lausch
Commercial Account Manager & Health Benefits Specialist, Members 1st Insurance Services
Ben Lausch, a Commercial Account Manager with Members 1st Insurance Services, has 16 years of experience in the insurance industry, serving the varying insurance needs of businesses and individuals in Central PA.



Lefevre
Phyllis Hicks, RN, BSN
Certified Application Counselor, Pinnacle Health

Phyllis Hicks, RN, BSN, is a nurse with more than three decades of clinical, corporate, and academic expertise in the area of health and wellness. 

As a member of the Harrisburg community for more than 25 years, Phyllis has developed relationships with a diverse group of organizations and individuals concerned with quality service and equal access to care in Central PA.






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