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Published: Wednesday, 10/2/2013 - Updated: 1 year ago

Consumers have variety of health-care plan options

BY TOM TROY
BLADE POLITICS WRITER
MARKET RESOURCES

■ Marketplace Web site: healthcare.gov
■ Marketplace hot line: 1-800-318-2596
■ Ohio Department of Insurance Web site: insurance.ohio.gov
■ Michigan Department of Insurance and Financial Services Web site: michigan.gov/​difs
■ A list of organizations providing enrollmentassistance: LocalHelp.HealthCare.gov
■ A list of Michigan groups providing enrollment assistance: enrollmichigan.com
■ Estimate tax credits using the Kaiser Family Foundation subsidy calculator: kff.org

Shopping for health care under the Affordable Care Act on Day One was not as easy as, say, shopping for a refrigerator.

Under 'Obamacare,' consumers have a large variety of options, depending on what level of coverage they want and which insurer they like. Prices also vary according to the number and ages of family members. A taxpayers’ subsidy, in the form of a tax credit, varies based on annual income.

And those details change depending on which state and county one lives in.

The only way to get a general idea of how much a plan would cost a consumer in Ohio was to go on the federal government's Web site, healthcare.gov, and actually starting an application for benefits. That involves providing one's Social Security number and details from one’s most recent income-tax return.

For people just trying to sample the market, the state of Michigan provided an on-line calculator that allows the user to run different consumer scenarios. The calculator is found at www7.dleg.state.mi.us/​perc.

The state of Ohio provides a link to a “subsidy calculator” created by the Kaiser Family Foundation at kff.org/​interactive/​subsidy-calculator, but no calculator as detailed as the Michigan site. The Kaiser calculator did not work when The Blade tried to use it late Tuesday, but it is active as of early today according to the Kaiser Family Foundation.

We ran several scenarios on the Michigan calculator and came up with the following examples.

● A Monroe County family consisting of one 36-year-old adult and three children under 20 with an annual income of $40,000 would expect to pay between $411 and $809 monthly for a “bronze” insurance plan. For that family, the government subsidy, in the form of a tax credit, would be $385, making a low-cost insurance policy possible for this family at about $26 a month, or up to $424 a month. If that same family preferred a “silver” plan, the lowest available cost would be $81, after the tax credit; for a “gold” plan, $154; and for a “platinum plan,” $223 for the lowest-cost version.

●For a Monroe County family of five with two adults aged 45 and an annual income of $85,000, the cost of a “bronze” plan — the economy plan — would range from $629 to $1,237 a month. That family would get a subsidy/​tax credit of $167, bringing the monthly cost of family insurance down to $462 a month and to as much as $1,070. The higher-level plans cost more.

● A Monroe County family of two adults aged 52 and two children aged 19 and 23, with family income of $110,000, would not qualify for a tax credit. Its bill would range between $727 and $1,430 a month for a “bronze” plan, between $825 and $1,875 for a “silver” plan, $954 and $2,163 for a “gold plan,” or $1,076 and $1,761 for a “platinum” plan.

A Web site run by the U.S. Department of Health and Human Services provided some basic numbers about insurance plans for individuals in Ohio.

According to that site, there are seven insurers offering a total of 66 qualified plans in Region 1, northwest Ohio. The cost of those plans ranged from $129 for a “catastrophic” plan — available to individuals younger than 30 — to $224 for the lowest cost “gold” plan.

Again, the costs rise the more the consumer prefers the security of a plan that pays a bigger and bigger share of the cost of coverage.

Each plan must cover the following categories of care: emergency, maternity, mental health, rehabilitative, preventive, and pediatric, as well as chronic disease management, prescriptions, and laboratory work.

After that, plans are ranked according to how much of the costs the plan covers — 60 percent for bronze, 70 percent for silver, 80 percent for gold, and 90 percent for platinum.

Contact Tom Troy: tomtroy@theblade.com or 419--724-6058 or an Twitter @TomFTroy.



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