The cost of a health plan depends on:n The ages of everyone applying for coveragen The size of your familyn Where you liven Whether you use tobacco (if you do, you’ll pay more)

What are cost sharing reductions?If you buy a health plan from the ”Silver” category through the Marketplace, and yourincome is below a certain level, you may get a discount on your health care services. Thislowers the cost you’ll pay out of your pocket for your doctor or hospital visits, prescriptions, etc.

Health Care Reform Answers

78141-0913Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.

This information is for illustrative purposes only and is being provided to help increase understanding of the impacts of some of the provisions of the Affordable Care Act (ACA). It does not attempt to cover all of the law’s provisions and is not intended as tax or legal advice. We encourage members to seek professional advice, including legal counsel, regarding how the new requirements may affect you.

Lots of changes are happening in health care.We’re here to help you understand what it means and what you may need to do.

What is the Affordable Care Act?The health care reform law, or the Affordable Care Act (ACA), was passed by the federalgovernment on March 23, 2010. The law makes health insurance available to more people.

What does the new law do? It makes insurance available to more people, so more people can get the care they need. And that is good news!n It expands the essential benefits and services covered by

health plans.n It allows you to compare health plans more easily, since

all insurance companies must show the benefits and costs of their health plans in the same format.

n You may be able to get help paying for a health plan.

How can Florida Blue help me?We’re here to help you understand how the law may change things for you and your family.

If you have any questions, we encourage you to call the phone number listed on this website or click Chat Now. Talk to us one-on-one for answers to your specific health insurance questions. We can explain your options and help you through the next steps to take.

What is the Marketplace?The government set up an insurance exchange Marketplace where people can shop and compare health plans online. We can walk you through the Marketplace, help you buy a health plan that meets your needs and then help enroll you in the plan. We’re with you every step of the way. Call the phone number on this websiteor click Chat Now for more details.

If you have any questions, we encourage you to call the phone number listed on this website. Talk to us one-on-one for answers to your specific health insurance questions. We can explain youroptions and help you through the next steps to take.

How will my health affectgetting health insurancecoverage?Everyone can get a plan. Beginning in 2014, you can’t be turned down or charged more for insurance even if you have been sick or have a health condition. Instead, everyone who applies for individual health insurance is guaranteed coverage.

Once you’re enrolled in a plan, your coverage cannot be cancelled if you have a health problem.

What do I need to do?Starting January 1, 2014, most everyone in the United States will need to buy a health plan or pay a fee. You can enroll in one of the new health plans fromOctober 1, 2013 until March 31, 2014.

What is the age limit to be qualified as a dependent?Your unmarried children or stepchildren (by birth, legal adoption, or legal guardianship) can stay on your health insurance policy until they reach age 30, unless they are able to get insurance through their job.

Health Care Reform Answers

78141-0913Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.

This information is for illustrative purposes only and is being provided to help increase understanding of the impacts of some of the provisions of the Affordable Care Act (ACA). It does not attempt to cover all of the law’s provisions and is not intended as tax or legal advice. We encourage members to seek professional advice, including legal counsel, regarding how the new requirements may affect you.

Can I get help paying for my healthplan?If you qualify, the government will help you pay a part of the cost for your health plan through the Marketplace. These lower costs are handled with a tax credit (or subsidy) called the advance premium tax credit. We can help you connect to the Marketplace to find out your actual tax credit amount. The tax credit can be applied right away to your monthly health plan premiums, so you get the lower costs immediately.

The tax credit amount depends on things like your household income, your family size and ages, as well as where you live.

Example of how a tax credit works with a health plan:The monthly cost for a health plan(cost depends on which health plan you choose)

$334 per month

Subtract the government tax credit(money paid to the insurance company)

– $183per month

You would pay $151per month

Single person, age 49, living in Duval County with an annual income of $25,000.

Are there other plansI can choose from?People under 30 and some people with limited incomes may buy what is called a “catastrophic“ health plan. It protects you from very high medical costs.

What are my plan options through theMarketplace?The Marketplace offers four “Metal” categories of health plans: Platinum, Gold, Silver and Bronze. These metal levels can help you compare plans. The four categories cover the same set of benefits, but vary based on the monthly premium amount and how much you pay out-of-pocket for health care services for things like doctor or hospital visits. Coverage is effective January 1, 2014.

What are the essential benefits required by the law? While Florida Blue covered most of these benefits and services before the new law, all of the new health plans for individuals and small businesses must include a comprehensive list of items and services known as ‘Essential Health Benefits’. These include things like emergency services, hospitalization, maternity and newborn care, mental health and substancedependency services, prescription drugs,preventive and wellnessservices, pediatric dentaland vision care. We canexplain your options andhelp you through the nextsteps to take.

Extra help for children...For kids under 19, all health plans on the Marketplace will include vision care and some will include dental care. You can buy similar plans from Florida Blue.

Do the plans include maternity coverage? Yes, as part of the Affordable Care Act, maternity coverage is now included in all our new plans.

Bronze

Silver

Gold

Platinum

Health Care Reform Answers

78141-0913Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.

This information is for illustrative purposes only and is being provided to help increase understanding of the impacts of some of the provisions of the Affordable Care Act (ACA). It does not attempt to cover allof the law’s provisions and is not intended as tax or legal advice. We encourage members to seek professional advice, including legal counsel, regarding how the new requirements may affect you.

Will I have to take a medical exam to get coverage?No. For new plans being sold starting October 1,2013, you can’t be denied health coveragebecause of your medical history. This means thatyour medical history cannot be used to determinethe cost of the health insurance coverage youchoose. Exception: If you’ve been enrolled in thesame plan since March 23, 2010, you may be ableto keep it. To add anyone to this particular plan, amedical exam or questionnaire may be required.

How can I save on my monthlypremiums?Generally, if you want to lower your monthlypayments, choose a plan with a higher deductibleand a higher coinsurance amount. The idea is thatthe more you share the cost of your health care, theless you will pay for the plan. We offer several planoptions to fit your monthly budget. And if you are eligible for a tax credit, you may be able to get helpfrom the government to lower the monthly cost ofyour health plan premium.

Do you offer dental insurance? Yes, you can purchase dental coverage as part of your healthplan or as a separate policy.

How do I choose a plan?It’s easy! You can use this website to find plans andprices right away, plus check if you qualify for a tax creditto lower your monthly premium. You can even create anaccount to save your information and return later.

Feel free to call us at the phone number listed on the website or click Chat Now,so we can help you get the plan that fits your needs and budget. We’ll help you enroll in a plan that works for you – whether on the Marketplace or not.

Can I keep my current health plan?If you had your Florida Blue health plan on March 23, 2010, you may be able to keep it.

Some health plans purchased after March 23, 2010, haveundergone changes to be consistent with the health carereform law, and may no longer be available to you onJanuary 1, 2014.

Call the phone number on this website or click Chat Now toget all of your questions answered about your plan.

If I purchase a health plan now – can Iswitch to a different one if I don’t like it?No. Special timelines now apply for enrollment. Each year therewill be an Open Enrollment Period when you select a plan.However, there are also Special Enrollment Periods for specialcircumstances, which include birth, marriage, loss of job, etc.

What are my options if I only needhealth coverage while I’m between jobs? You may qualify for coverage under a Special Enrollment Period.

If I purchase a health plan, do I still need Supplemental Insurance?Supplemental insurance such as Accident, Critical Illness, andHospital Indemnity can help protect your savings, since they pay cashdirectly to you to help pay for deductibles and copays, mortgage/rent,childcare or other costs, while you recover.

While your health care plan is intended to provide coverage for mostmajor medical costs, if you’re out of work or on a fixed income, youmight not be able to cover unplanned or even everyday expenses.

How Florida Blue Can HelpAt Florida Blue, we’re with you every step of the way. We’ll help you make sense of health insurance and get the care you need to be ashealthy as you can be. If you have any questions, we encourage you to call the phone number listed on this website, click Chat Now, oryou can visit a nearby Florida Blue Center (floridabluecenters.com).