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Healthcare for the College Student

Healthcare for the College Student. Pierce Student Health Center. How old are you?. 15-24 25-34 35-44 45-54 55-64 65+. Do you have health insurance?. Yes, I pay for my own Yes, I’m on my parents/guardian’s insurance No I don’t know. 30% 19% 47% 5%.

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Healthcare for the College Student

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  1. Healthcare for the College Student Pierce Student Health Center

  2. How old are you? • 15-24 • 25-34 • 35-44 • 45-54 • 55-64 • 65+

  3. Do you have health insurance? • Yes, I pay for my own • Yes, I’m on my parents/guardian’s insurance • No • I don’t know 30% 19% 47% 5%

  4. Why talk about health insurance? • Everyone MUST have health insurance by January 1, 2014 • If not, you will be fined during tax time • 1% or $95 in 2014 • 2.5% or $695 in 2016 • Affordable Care Act (ACA): new laws regarding health insurance

  5. Health Insurance Terms • Co-pay: money you pay before seeing a doctor • Co-insurance: money you owe for extra health services not covered under your plan • Monthlypremium: amount you pay an insurance company per month

  6. Health Insurance Terms • Out-of-pocket costs: total amount you will spend for the year • Preventativecare: visiting a doctor to prevent or detect illness at earlier stage • Primarycare: routine physical exams

  7. Already have insurance? • New protections and benefits • More, and free, preventive care • Diabetes and cholesterol screenings, prostate exams, mammograms and flu shots • Catch the little things before they turn into bigger problems

  8. Have children? Under parent’s plan? • Stay on parent’s insurance until 26 years old • Doesn’t matter if child: • Doesn’t live in same state • Don’t make his/her own money • Is married

  9. But I can’t afford health insurance! • Catastrophic plans • For anyone under 30 years old • Covers: • 3 primary care visits per year • Free preventative services • More services, but large fee • Expanded Medi-cal • Tax credits

  10. Am I eligible? • Who’s eligible? • Legal California residents • Who’s not? • Undocumented immigrants • Currently incarcerated individuals

  11. Tax Credits • Helps you buy health insurance • Credit applied toward cost of insurance plan • Amount of credit changes depending on income

  12. Tax Credit Example • Your income: $26,000/year • Your credit (based on $$): $150/month • Bronze premium plan cost: $200/month • Your premium after credit: $50/month

  13. Insurance Levels • Bronze: 60/40 • Silver: 70/30 • Gold: 80/20 • Platinum: 90/10 • # on left: % of what insurance will pay • # on right: % of your co-insurance • Same set of benefits, just higher premium and more total out of pocket costs (depending on level)

  14. Levels Example • You break your leg and must go to the doctor. It will cost a total of $5,000 to fix your leg. • Bronze: 60/40 • Silver: 70/30 • Gold: 80/20 • Platinum: 90/10

  15. Tax Credit Example Bronze Platinum • Monthly premium: $200 • Tax credit: $150 • After credit: $50 • Insurance pays: • $5,000 x 60% = $3,000 • You pay: • $5,000 x 40% = $2,000 • Monthly premium: $500 • Tax credit: $150 • After credit: $350 • Insurance pays: • $5,000 x 90% = $4,500 • You pay: • $5,000 x 10% = $500

  16. Remember… • the lower the premium, the higher the out-of-pocket costs when you need care • â premium = á out-of-pocket • the higher the premium, the lower the out-of-pocket costs when you need care • á premium = â out-of-pocket

  17. Ask yourself… • Do you expect a lot of doctor visits or need regular prescriptions? • If yes, maybe a Gold or Platinum plan • If no, maybe a Bronze or Silver plan • BUT…get in a serious accident or have an unexpected health problem? • Bronze and Silver plans = paying more.

  18. Based on your lifestyle, which level would you choose? • Bronze • Silver • Gold • Platinum • Catastrophic • I don’t know/ I need more information 22% 24% 15% 17% 0% 22%

  19. How do I Enroll? • www.CoveredCA.com • Marketplace/Exchange: where to buy insurance • Call: (888) 975-1142 • Aug. 19 – Sept. 30: Mon-Fri 8 AM – 6 PM • Starting Oct. 1: Mon-Fri 8 AM – 8 PM Sat 8 AM – 6 PM • Open enrollment: Oc. 1, 2013 – Mar. 31, 2014 • Medi-Cal applications go year round

  20. Insurance Plan Coverage • Visitwww.CoveredCA.comor call (888) 975-1142 now for help on plan prices and comparisons • Open enrollment starts Oct. 1, 2013 • Until Mar. 31, 2014 • Jan. 1, 2014 – need insurance!

  21. Questions? Comments?

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