With the passage of the Affordable Care Act (ACA), commonly known as ObamaCare, Iowans have additional options when purchasing private health insurance. Iowa did not choose to implement a state-based insurance marketplace. Instead, Iowa residents who plan to compare and purchase insurance should visit the federal Marketplace. As of March 1st of 2014, over 15,000 Iowans had selected a Marketplace plan.

Iowa did move forward with the expansion of Medicaid eligibility guidelines as of January 1st, 2014. This makes Medicaid coverage available to thousands of additional citizens of the state, and helps make sure that Iowans who make too little to qualify for subsidies in the Marketplace will be able to find coverage through Medicaid.

Purchasing Insurance in Iowa

Applications can be made through the Marketplace in several ways. Iowans can choose to make an online application, which is often the easiest and fastest way to apply. Citizens can also apply over the phone by calling 1-800-318-2596 anytime. Assistance is available 24 hours a day, 7 days a week. In addition, Iowan residents can apply in-person with the help of an assister. To find a nearby assister, visit the Local Help website.

Regardless of how they are submitted, all applications are reviewed automatically for eligibility for Medicaid or the Children’s Health Insurance Program (CHIP), as well as any financial assistance that may be available. Iowans who earn between 100% – 400% of the federal poverty level will be eligible for some form of assistance on monthly premiums. Those who make between 100% – 250% of the poverty level will qualify for additional assistance with cost-sharing, such as copayments and deductibles. For the rest of the open enrollment period, which ends on March 31st, 2014, the 2013 poverty levels will be used. For a family of four, that was $23,550.

Uninsured Iowans must obtain insurance coverage by March 31st, 2014 in order to avoid being assessed a tax penalty. In general, insurance purchased by the 15th of the month will begin on the 1st of the next month. Iowans who have job-based insurance, Medicare, or other qualified health insurance are considered covered under the ACA and will not need to purchase private insurance. If insurance is unattainable for some reason, Iowans can apply for an exemption to avoid paying the tax penalty. Just because this select group of Iowans are exempt from paying the tax penalty does not mean that they have health care coverage. The exemption merely means that they do not have to pay the penalty.

Medicaid and CHIP in Iowa

Because Iowa is expanding its Medicaid eligibility guidelines, there is a good chance that lower-income citizens will qualify, even if they have been denied in the past. To apply for Medicaid, Iowans can fill out a Marketplace application or contact the state office directly.

For moderate income Iowa families who make too much to be eligible for Medicaid, the Children’s Health Insurance Program (CHIP) can help with providing coverage for uninsured children. CHIP, called Hawk-I in Iowa, can assist moderate income families with checkups, immunizations, doctor visits, dental and vision care, and more. For more information, visit the Hawk-I website. Families whose children qualify for CHIP can still use the Marketplace for adult coverage in the household.

The ACA has changed a lot about how Iowans access health insurance. A centralized Marketplace makes it easy to view, compare, and choose a private health insurance plan. Those who are uninsured may qualify for Medicaid or CHIP under expanded guidelines, or gain assistance with Marketplace insurance coverage. Knowing all the options and choosing what’s best for each family will help Iowa move toward a healthy future.

 

Sources:

http://www.healthcare.gov/

http://kff.org/health-reform/state-indicator/state-marketplace-statistics-2/

https://www.healthcare.gov/how-do-i-apply-for-marketplace-coverage/

https://localhelp.healthcare.gov/

http://aspe.hhs.gov/poverty/13poverty.cfm

https://www.healthcare.gov/what-if-someone-doesnt-have-health-coverage-in-2014/

https://www.healthcare.gov/exemptions

https://www.healthcare.gov/are-my-children-eligible-for-chip/

https://dhsservices.iowa.gov/apspssp/ssp.portal