Affordable Care Act covers restaurant workers, sub teachers, others with income

Restaurant workers, substitute teachers, home health workers, self-employed people, and any other Valley residents who are without health insurance and have some sort of income, you may very well qualify for large tax credits and cost-sharing subsidies that would help pay for health insurance under the Affordable Care Act for coverage in 2015.

The next ACA Open Enrollment runs from Nov. 15 to Feb. 15 and the fees for not having insurance are tripling this next go-around. Plus, you never want to be without health coverage, anyway, because you never know what the future holds. You could get into an accident, come down with a serious illness, have a heart attack, or any number of other unfortunate events that could land you in the hospital.

And because of the Affordable Care Act, health insurance companies can’t deny you coverage or even charge you more for a pre-existing condition. There also are strict limits on how much you would have to pay for services each year (maximum out-of-pocket costs), there is no charge for contraceptives (even tubal ligation), and certain preventative services are now free or carry a minimal cost.

Getting enrolled is fairly painless if you have the help of a certified assister like me or a couple of my coworkers at Mat-Su Health Services on Spruce Avenue in Wasilla. We don’t charge for our services and the process usually takes only about an hour.

There are income guidelines to qualify for the tax credits and cost-sharing reductions, however. For example, if you are single, you would have to have an adjusted gross income for 2015 of at least $14,580 and cannot make more than $58,320. For a married couple with no dependents, they would have to have a combined income of at least $19,660 and couldn’t bring in more than $78,640. A tax household of four would need at least $29,820 and couldn’t make more than $119,280. A tax household of eight would need a combined income of at least $50,140 and no more than $200,560 to qualify for help paying for ACA coverage.

The lower your income (at or above the Federal Poverty Level), the more help you would get. Many folks whose incomes are at the poverty level or even $10K above it will qualify for health plans with a $0 monthly premium and a deductible of only $250. There’s really no reason to pass that up if you don’t have other viable health care options.

Unfortunately, if your income drops below the Federal Poverty Levels listed above, you won’t be able to get the tax credits that make ACA coverage affordable and you probably won’t qualify for Medicaid unless you have children and meet other guidelines. Those who fall into that category are left without many options since Gov. Sean Parnell did not accept the Medicaid Expansion under the ACA for our state.

Those who already are covered through an employer, Medicare, Medicaid, and Veterans benefits would not qualify for ACA coverage and would not have to worry about the fee.

Alaska Natives and American Indians are discovering that although they have Indian Health Services, they can supplement that with an ACA policy and actually qualify for much more in tax credits and cost-sharing reductions than non-Natives.

Those who enrolled in an ACA plan with Premera Blue Cross Blue Shield or Moda Health this past year will be getting renewal notices in the mail or through their email accounts both from the Health Insurance Marketplace (healthcare.gov) and their insurance carrier. It is recommended that you don’t “auto-renew” your current plan and, instead, look at what’s being offered from Premera and Moda for 2015 to make sure you can’t get a better deal this time around.

You definitely will need to submit a new ACA application for next year if your income is changing or you’ve had other life events (marriage, baby, divorce, a change in tax dependents) that would affect your tax credits and other assistance you can receive for 2015.

If you have any questions or need assistance with either a new ACA policy or an existing one, please call Kate, Tonya, or Joni at Mat-Su Health Services at 376-2411.

More information also is available online at healthcare.gov. A redesigned, and more user-friendly version of the site will go live Oct. 6.

K.T. (Kate) McKee is a Certified Application Counselor for the Affordable Care Act at Mat-Su Health Services Inc., in Wasilla.