HUDSON–Lisa Thomas, senior program director at the county Healthcare Consortium and a navigator for the New York Health Benefit Exchange under the Affordable Care Act, recently outlined for county supervisors the plan to extend health insurance to the 2.7 million residents of the state who currently have no coverage.
There are an estimated 7,300 people in Columbia County between the ages of 19 and 64 who have no health insurance, and Ms. Thomas said at her November 13 presentation that for the first time, many will now be able to afford insurance.
Individuals will be able to select from among 16 health and 10 dental plans. Health plans now must have 10 essential services, and will include: outpatient services; specialists; mental health/substance abuse services; hospitalization; drugs; pediatric care and vision. These plans are offered on a tier system, ranging from 60%-90% reimbursement. Individuals making less than $45,960 annually are eligible for tax credits, and cost-sharing kicks in at an annual salary below $28,725.
The deadline for enrollment is December 15, 2013 for coverage beginning January 1, 2014. Under the individual mandate, a person must be enrolled prior to March 31, 2014 to avoid penalties.
Special rules pertain to small businesses. A tax credit of up to 35% is available to small businesses that offer coverage to employees. These businesses must have fewer than 25 employees, with an average annual salary of $50,000 or less, and the employer must contribute at least 50% of the premium. Small businesses with 50 employees or fewer can shop for insurance plans through the marketplace.
Income qualification is based upon 2012 figures reported to the Internal Revenue Service. Enrollees must verify that their 2012 income is a reasonable expectation for current year’s income. And those currently receiving Medicare benefits do not need to take any action.
There are five full-time navigators who cover Columbia and Greene counties. Appointments may be made by calling 518 822-9600 or by visiting the website at www.Nystateofhealth.ny.gov, selecting the “Resources” tab at the top, then downloading the IPA/Navigator Site Locations File. Columbia County is on page 30 and lists the address, phone number and languages spoken at each location. Navigators are on hand early mornings, evenings and weekends, as well as regular daytime hours, to accommodate the highest number of people.
There also is a Customer Service Line, 855 355-5777 for additional questions.