bluekchealthcareEnrolling in health insurance can be confusing. That’s why Blue KC is here to help.

From making sense of the Affordable Care Act to explaining subsidies to helping you navigate the Health Insurance Marketplace, Blue KC has the answers. Whether you’re self-employed, a college student or a parent looking to keep your children covered, we have resources you need to find the right coverage for you and your family.

Have questions about health insurance?

You’re certainly not alone. Luckily, this is a good place to start.

Why do I need health insurance?

Under the Affordable Care Act (ACA), the law requires that everyone has health insurance. But more than that, health insurance is important because it protects you and your family from those unexpected (and often high) medical costs, not to mention that most plans include a set of preventive care services, such as vaccines or screenings, for free.

When can I get health insurance?

You can get health insurance through your employer, or you can purchase health insurance from the Health Insurance Marketplace during the annual Open Enrollment Period, which takes place from November 1, 2016 to January 31, 2017. You might also be able to purchase health insurance outside of Open Enrollment if you’ve experienced a qualifying life event in the last 60 days.

Once Open Enrollment begins on November 1, you can shop for plans on or through a health insurance broker.

How do I select the right plan for me or my family?

The right plan for you or your family should be based on needs, like how often you visit the doctor or how much you want to pay monthly for coverage. Health insurance plans are offered in four metal levels – Platinum, Gold, Silver and Bronze, with Platinum plans being the most expensive. If you’re unclear of which metal level might be right for you, take a look at the graphic below:

Bronze Coverage Bronze Coverage
  • Looking for a lower monthly health insurance bill (premium).
  • OK with spending a little more when you visit a doctor or hospital (out-of-pocket costs).
Silver Coverage Silver Coverage
  • Looking for a moderate monthly health insurance bill.
  • OK with spending a moderate amount when visiting a doctor or hospital.
Gold Coverage Gold Coverage
  • OK with a higher monthly insurance bill.
  • Looking for low costs when you visit a doctor or hospital.
Platinum Coverage Platinum Coverage
  • Looking for ongoing medical care.
  • Willing to pay a high price to get it.

Where can I apply for health insurance during Open Enrollment?

If you are an individual looking for coverage, you can sign up on the Health Insurance Marketplace (Exchange) at or by contacting your health insurance broker.

How much will it cost me?

The cost of your health insurance plan will depend on your lifestyle and the type of plan you purchase (Platinum, Gold, Silver or Bronze).

Bronze plans are recommended for those looking for a lower monthly health insurance bill (also known as a premium). However, this also means you may have to pay a little more when you visit a doctor or hospital, depending on your plan’s copay, deductible and out-of-pocket maximum costs. In all, Bronze plans pay for about 60 percent of covered medical costs.

Silver plans come with a slightly higher monthly bill. However, your out-of-pocket costs would be lower compared to a Bronze plan. Silver plans pay for about 70 percent of covered medical costs.

Gold plans have an even higher monthly insurance bill, yet the out-of-pocket costs with a Gold plan are lower. Gold plans pay for about 80 percent of covered medical costs.

Platinum plans have the highest monthly insurance bill of all the plan levels. This is recommended for people with lots of ongoing medical care who are willing to pay a high price to receive that care. Blue KC does not currently offer the Platinum plan.

Whichever plan you purchase, it’s important to remember that you could be eligible for financial assistance from the government in the form of a subsidy (also known as a Premium Advanced Tax Credit) to help save on your monthly bill (premium).

How can I save on monthly health insurance payments?

Under the Affordable Care Act (ACA), you may be able to get financial help when you buy health insurance through the government. One form of health insurance savings is a premium tax credit from the government to lower your monthly health insurance payments (or premiums).

When it comes to tax credits, you have two options. You can choose to have your tax credit paid directly to the insurance company so that you pay less each month (which is called an Advanced Premium Tax Credit), or you can wait to get the tax credit in a lump sum when you do your taxes the following year.

Are there other ways to save on health insurance and healthcare costs?

Yes. A Cost Sharing Reduction is another type of financial assistance offered by the government. Cost Sharing Reductions help with out-of-pocket costs when care is received – like when you go to the doctor or have a hospital stay. This type of savings is only available to people with household incomes between 100 percent and 250 percent of the federal poverty level. You must also have a Silver level health insurance plan to qualify for this type of discount.

Can I really be penalized if I don't get covered?

Yes. People who don’t get minimum essential coverage may be subject to fines from the government for any month they didn’t have coverage when they file their taxes. So whether it’s a traditional plan through your employer or the Federally Facilitated Marketplace Exchange or registering for programs like Medicaid, Medicare and The Children’s Health Insurance Program (CHIP), you need to sign up for some kind of coverage or apply for an exemption. Exemptions may be available to people who experience circumstances that may prevent them from getting affordable coverage or who have a gap in their coverage of less than three months. You can apply for an exemption through the Federally Facilitated Marketplace or when you file your taxes for the year.

The penalty for not having coverage in 2017 will be $695 per adult and $347.50 per child in your household (up to $2,085) or 2.5 percent of your household income, whichever is larger.

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