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As a mom, one of the most important things is keeping your children safe and healthy, right? Maybe you don’t have health care yet, or maybe you’re not sure where to get started. I mean, we hear all about the Affordable Care Act (ACA) on the news and media everywhere, but do you really know what it means for YOU, or where you can get more information, or to start the enrollment process?
If not, you’ve come to the right place!
The Basics
Let’s start with the basics. I want to help you realize what is available, so that when you go to the enroll you know what you’re looking for.
Since, our concern is our children first, let’s look at what is available to them with the ACA.
When it comes to the ACA, where you fall when it comes to coverage is based primarily on your income. So depending on what you (& your spouse) make, your child(ren) could be eligible for Children’s Health Insurance Program (CHIP, or you may also hear it referred to as Child Health Plus) or Children’s Medicaid. The bottom line here, your child should NOT go without health insurance.
Children’s Health Insurance Program and Children’s Medicaid
The rules for qualification for CHIP are pretty straight forward, your child must be under the age of 19 and fit into the income brackets that are set forth by the government.
Children’s Medicaid does not have a monthly premium associated with it, so the income guidelines are lower, however, even if you make more than the Medicaid guidelines, your child will be eligible for CHIP.
See the income bracket below to determine where your child would fall.
Click on the picture to view larger.
When you apply for CHIP or Children’s Medicaid you’ll be doing it directly through the New York State of Health Exchange, and if you don’t live in New York State you can actually start the whole application process through websites like UnitedHealthcare’s. It’s a pretty simple and straight forward process – You begin by entering your age and zip code, and then it has you fill in some additional identifying information, as well as allow you to add on additional people (so, your spouse, and/or your children).
One note, this is not the formal enrollment process. It does ask you for an estimate on your household income. This is because it will provide you with the information where you should fall, based on that income you’ve provided. However, once you get into the formal application, you will need to provide concrete information, which could lead to a change in what you’re eligible for. It shouldn’t fluctuate much, I just wanted to give you a head’s up (unless your estimate is hugely off).
Medal Level Plans and Adult’s Medicaid
Now that we have your child(ren) covered, we need to you get insured as well. Thankfully, if you’ve already been following the application process so far, you don’t need to do much else in order to determine what you’re eligible for.
The medal levels are, Bronze, Silver, Gold and Platinum – The cost and benefits associated with each go up from bronze.
When you enter your income, the system will take that into account, as it does for you child. If you are eligible for Adult’s Medicaid, it will advise you of that. However, if you are above in the income brackets for Medicaid, the choice is yours!
Obviously if you visit the doctor frequently, or believe that you will need to, the higher the medal level you will want to go. You may pay more each month for your premium, but you won’t have high copays / co-insurances / deductibles.
Below are the income guidelines for Adult Medicaid
Click on the picture to view larger.
You can read more about each medal level by clicking here.
The goal here is to get everyone affordable health insurance. If you don’t qualify for Medicaid, there are still credits available to you via the government. My recommendation is to start the enrollment process now, to learn what you’re eligible for.
Health Insurance can be a highly confusing thing. If you don’t understand the terms or just aren’t really sure where to start, I want to help! I’ve been working in health insurance for the past 8 years, and have a pretty wide knowledge – so please feel free to ask away in the comments.
Additional Resources:
Health Insurance Exchange 101
Shopping for Health Insurance
Health Insurance Definitions and Terms
Your turn!
Have you personally enrolled in health insurance via the Exchange? If so, what was your experience?
When in comes to health insurance, what other questions do you have? I’d love to help you understand all there is to know!
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