The Artists Health Insurance Resource Center www.ahirc.org A program of The Actors Fund www.actorsfund.

org Dan Kitowski, Director of Health Services - Western Region 323 330-2432 / dkitowski@actorsfund.org

Children under age 19 with pre-existing conditions cant be denied coverage. Young adults up to age 26 can stay on or enroll in their parents coverage. Insurers cant retroactively cancel the policies of people who get sick. Insurers cant impose lifetime dollar limits on medical benefits. All new plans must cover certain preventive services, such as mammograms and tetanus shots, for free.

Uninsured people with pre-existing conditions may be eligible for coverage through PCIP.
Pre-Existing Condition Insurance Plan www.wship.org/PCIP-WA
Help for the uninsured with pre-existing medical conditions thru a temporary high-risk pool until January, 2014

Insurers cant refuse coverage to anyone. Most people will be mandated to have coverage or pay a penalty. New insurance marketplaces, called Exchanges, will offer insurance to those who dont get it elsewhere. Subsidies will be available to people who buy insurance through an exchange with income less than 400% of the Federal Poverty Level. ($43,320) Employers with 50 or more employees who dont offer insurance will be fined.

All new plans will offer at a minimum an essential benefits package which limits outof-pocket medical expenses. Including: Ambulatory care Emergency care and Hospitalization Maternity and newborn care Mental health and substance abuse Prescription drugs Preventive and wellness services

 If

your income is $10,830 - $43,320 (single), you will receive a subsidy to buy insurance through an exchange. Subsidies will cap the amount you spend on premiums in relation to your total income. Subsidies will also cap your annual out-ofpocket medical costs.

Example: a person who makes $21,000/yr will have their premiums capped at 6.3% of their income, and their annual out-of-pocket medical costs will be limited to $1,983/yr (excluding premiums).

 Under

age 30: high-deductible plan option (2014). Prevention benefits and 3 primary care visits are exempt from deductible.
age 26: can stay on or enroll in parents plan. Applies regardless of living situation, marital status, student status, or financial dependence. Exclusion: if you have
access to insurance through an employer.

Under

 If

you have a new policy that began on or after 9/23/2010, you can get certain preventive services for free:
Blood pressure, diabetes & cholesterol tests Breast, colon & cervical cancer screenings Vaccines, immunizations & flu shots HIV & STD testing Screenings for healthy pregnancies Well-child visits

Available beginning 2010 tax year

Employers with fewer than 25 FTEs employees with average wages of less than $50,000 that purchase health insurance for employees are eligible for the tax credit To be eligible, employer must offer a group health plan & contribute at least 50% of premium cost 2010-2013: credit max is 35% of employer contribution (25% for tax exempt/non-profits); will increase to 50% (35% for non-profits) in 2014

Small business will file Form 8941 when they file income tax returns Tax exempt organizations will claim the tax credit on a revised Form 990-T

www.irs.gov/newsroom/article/0,,id=223666,00.html

 Artists Office

Health Insurance Resource Center: www.ahirc.org of Consumer Information and Insurance Oversight: www.hhs.gov/ociio

Federal Kaiser

health care reform website: www.healthcare.gov

Family Foundation: www.kff.org

Employment-related coverage Purchase private plans Government-subsidized programs

If you leave/get laid off from a job COBRA Continuation of employer benefits for at least 18 months 60 days to decide/elect coverage Sticker Shock guaranteed coverage, but can be expensive. Pay full premium, at group rate.

Rights & Protections right to receive care in a

life-threatening emergency at any hospital regardless of insurance status.

Words to Know HMO, PPO, High Deductible Plan or Catastrophic Coverage.

Choose a carrier & type of policy to meet your needs and your budget.

 Colleges & Universities Alumni Associations Associations Plans Chamber of Commerce

www.seattlechamber.com

Internet brokers
www.ehealthinsurance.com

 Medicaid

Comprehensive Very low income AND fit one of these categories: pregnant, blind, disabled, 65 or over, 18 or under, or be a parent living with child 18 or under No premiums As part of health care reform, income will be the ONLY eligibility requirement in 2014.
www.dshs.wa.gov

Washington Basic Health

Low-cost, comprehensive coverage thru private health plans for residents with limited incomes. www.basichealth.hca.wa.gov

Washington Health Program

2 plans: $75,000 or $100,000 in health insurance coverage per year. Low-cost, age rated. www.washingtonhealth.hca.wa.gov

Free, sliding scale, lower cost clinics Washington Association of Community & Migrant Health Centers
25 community health centers for low income and uninsured populations www.wacmhc.org

Qliance

Sliding-scale clinics

Primary and preventive care for a monthly fee www.qliance.com

Bureau of Primary Care: ask.hrsa.gov/pc

Dental discount plans and dental insurance Dental schools

University of Washington, School of Dentistry

Negotiate with your dentist Many of the Community Clinics have lowcost or free dental clinics for people with low incomes.