Healthcare Reform for the Individual

Gallaher Insurance Group

The law requires health insurance to be "guaranteed issue". That means a person can't be denied coverage or charged more because of a pre-existing health condition. Individuals not covered by a government health plan have three choices:

  1. Obtain coverage through their employer, if available
  2. Buy a plan through the individual market exchange or the traditional market
  3. Be uninsured and pay a penalty, unless exempt.

Exchange plans will be offered in a tiered format:

  1. Bronze (Pays 60%)
  2. Silver (Pays 70%)
  3. Gold (Pays 80%)
  4. Platinum (Pays 90%)

Each tier will have several options to choose from and will include the "Essential Health Benefits". Bronze plans will have the lowest monthly premiums, but cost shares will be more when health care services are provided. Cost shares are co-pays, deductibles etc.

To qualify for a subsidy, your income must be 133%- 400% of the Federal Poverty Level.

  • For an individual that equals $15,282 to $45,960 per year
  • For a family of four that equals $31,322 to $94,200 per year.

Please refer to this website and use the calculator to estimate your premium and possible subsidy: http://kff.org/interactive/subsidy-calculator/

Our staff has been certified and trained to educate you about the Affordable Care Act (Obamacare). Call us and we will guide you through this process.

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