What is the marketplace?

Preventive care Hospitals Physicians Prescription drugs Mental health Rehabilitation Habilitation services Substance abuse Dental and vision for children Maternity care Essential Health Benefits Coverage

Levels of Coverage

Insurance companies won’t be able to turn people down because of pre-existing conditions, including pregnancy and disability. This took effect in 2010 for children and on Jan. 1, 2014 for everyone. You can get lower costs on coverage: The Marketplace application will tell you if you’re eligible for a new way to get lower costs on your monthly premiums or out-of- pocket costs for private insurance. You’ll also learn if you can get free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). You can get help in your area: Navigators are available to give you personalized assistance with the process. Security and Control

Financial Protections No annual or lifetime limits Spending caps will limit the amount consumers pay out of pocket each year. Insurance companies have to spend at least 80-85% of premiums on medical care. Eligible for tax credits Insurers must justify premium increases

Depending on the plan you choose in the Marketplace, you may be able to keep your current doctor. Most health insurance plans offered in the Marketplace have networks of hospitals, doctors, specialists, pharmacies, and other healthcare providers. When comparing plans in the Marketplace, you will see a link to a list of providers in each plan’s network. Can I keep my own doctor?

Moderate-Income Families Families and individuals will receive tax credits to help pay for health insurance, depending upon income. Tax credits are available to everyone between 400% and 133% of the Federal Poverty Limit to make purchasing insurance more affordable. (Everyone below 133% FPL will be part of the Healthy Michigan program that begins April 1 st. ) Tax credits are designed to keep premium costs between 2%-8% of income, on a sliding scale.

Cost-Sharing Assistance

What about Medicaid? State health insurance programs under Medicaid will cover all families and individuals with incomes up to 133% of the Federal Poverty Level ($15,282 for an individual, $31,322 for a family of four) In Michigan, the expanded Medicaid program will not begin until April 1, 2014 Even if you were told you didn't qualify for Medicaid in the past, you may qualify under the new rules. Eligibility remains the same for women and children 10

Job-Based Insurance If you have job-based insurance, you’re considered covered. You may be able to change to Marketplace coverage Your income will determine your eligibility for lower cost premiums

By 2014, you must...

What about the fees?

What about small business? No mandate on small businesses Rewards good actors with subsidies Small businesses and non-profits qualify Credits carry over up to 20 years Maximumsubsidy is 50% for smaller businesses

How does the marketplace work?

Navigators are here to help

What documents do I need? Social Security Numbers (or document numbers for legal immigrants) Employer and income information for every member of your household who needs coverage (for example, from pay stubs or W-2 forms—Wage and Tax Statements) Policy numbers for any current health insurance plans covering members of your household

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