Get Lower Costs on Your Health Coverage Fact Sheet

Financial Help to Lower the Cost of Health CoverageDepending on how much you earn, you may qualify for financial help to lower the cost of health coverage. There are three new ways to get financial help through Washington Healthplanfinder.

1. Lower costs on monthly premiums. Tax credits help lower the cost of your health insurance premium payments each month. Or, instead of paying lower monthly premiums, you can choose to take the tax credit all at once after you file your taxes. An individual making up to $45,960 and a family of four making up to $94,200 may qualify for lower monthly premiums.

2. Lower costs at the doctor’s office. Cost-sharing reductions lower the amount of health care costs you pay at the time of medical care, such as when you visit the doctor’s office.

3. Free coverage. Starting in 2014, Medicaid or Washington Apple Health will be available to more people. An individual making less than $15,857 and a family of four making less than $32,500 can qualify for free health coverage.

When you fill out your application for free or low-cost health insurance on Washington Healthplanfinder, the cost of each health plan you see will automatically include the amount of financial help you may qualify for.

There is a new way to find health insurance in Washington:

a customer-friendly, online marketplace called Washington

Healthplanfinder. Individuals and families can find, compare and

enroll in a health plan that fits their needs and budget.

www.wahealthplanfinder.org

* These estimates are based on an average Silver plan rate for Washington state, adjusted for premium inflation and age rating. Actual costs may vary.

Example: Estimated Financial Help for a Family of 4*

Household Income

You Get (Federal Tax Credits)

You Pay (After Tax Credits)

Less than $32,500 Medicaid pays for coverage Coverage is free

$40,000 $426/month $164/month

$70,000 $334/month $549/month

$90,000 $171/month $713/month

Estimating Your Monthly Premiums

The amount of your tax credit depends on household income and family size. Tax credits are available for individuals and families who:

• Meet the Washington state residency requirement

• Meet the U.S. citizenship or lawfully present immigrant requirements

• Meet certain income requirements

• Do not have access to health insurance through their employer

• Do not have access to health insurance through a public program, like Medicaid or Medicare

Lower Costs on Monthly PremiumsThrough Washington Healthplanfinder, you may be able to lower the costs of your health insurance coverage by paying lower monthly premiums. These lower costs come from a new tax credit. A tax credit is an amount of money you may receive from the federal government. The amount you save with the tax credit depends on your family size and how much money your family makes each year. The lower your income, the lower your costs will be.

Tax credits are available only through Washington Healthplanfinder. You must enroll in a health plan through Washington Healthplanfinder if you want to get tax credits to lower your monthly premium costs. You will see the amount of savings you are eligible for when you fill out your Washington Healthplanfinder application after October 1, 2013. Prices shown for insurance plans will reflect the lower costs.

Tax credits can be used when you enroll. Tax credits can be applied to the cost of your health plan right away—or you can receive a refund when you file your tax return. Either way, to receive a tax credit, you need to file an annual tax return.

There is a wide range for tax credit eligibility. An individual making up to $45,960 and a family of four making up to $94,200 can qualify for tax credits.

Tax credits are paid to your health plan. These tax credits are paid by the federal government directly to the health plan you choose through Washington Healthplanfinder. This lowers the cost you pay for the health plan.

www.wahealthplanfinder.org

Through Washington Healthplanfinder, you may be able to lower the costs you pay when you get medical care, such when you go to the doctor’s office or hospital. This will happen through cost-sharing reductions. Cost sharing is when your health plan pays for some of your health care costs and you pay the rest. You and the plan “share” the costs. For example, if you have a $100 medical bill, your plan might pay $80 and you could pay $20. With cost-sharing reductions, you would pay even less.

When you apply for coverage on Washington Healthplanfinder, you will learn if you are eligible for cost-sharing reductions. This depends on your income and family size. You may qualify if your household income is below the amounts shown in the chart to the right.

Visit wahealthplanfinder.org to see if you qualify for financial help.

Family Size Household Income

Individual Up to $28,725

Family of 2 Up to $38,775

Family of 3 Up to $48,825

Family of 4 Up to $58,875

Family of 5 Up to $68,925

Family of 6 Up to $78,975

Cost-Sharing Reductions Depend on Your Income

Cost-sharing reductions are available only through Washington Healthplanfinder. You must enroll in a health plan through Washington Healthplanfinder if you want to lower the amount you pay when you go to the doctor’s office.

Cost-sharing reductions apply only to Silver plans. Plans on Washington Healthplanfinder are separated into three different categories: Bronze, Silver and Gold. These categories are based on how much of your medical costs you pay and how much the plan pays when you get medical care. They are not based on plan quality. If you qualify for cost-sharing reductions, you must enroll in a Silver plan to get the savings.

Lower Costs at the Doctor’s Office

www.wahealthplanfinder.org

Free Coverage Starting in 2014, free health insurance will be available to more people than ever before. This coverage is paid for by Medicaid, also known as Washington Apple Health. An individual making less than $15,857 or a family of four making less than $32,500 can qualify for free health coverage. The household income limit for children and pregnant women is much higher.

For additional questions, please call 1-855-WAFINDER (1-855-923-4633) or email us at customersupport@wahbexchange.org.

You can apply for free coverage through Washington Healthplanfinder. There are three ways to renew or apply:

• Online at wahealthplanfinder.org

• By phone at 1-855-WAFINDER (1-855-923-4633)

• In-person at a local organization—find the organization closest to you at wahealthplanfinder.org

Finding out if you qualify for free coverage is fast. It used to take 45 days to find out if you can get free or low-cost health plans. Now it should take about 45 minutes with Washington Healthplanfinder. You will need this information:

• Household monthly income

• Social Security number and date of birth for each person in your household applying for free coverage

• Immigration information, if that applies to you

Visit wahealthplanfinder.org to see if you qualify for financial help to lower the cost of health coverage.

www.wahealthplanfinder.org