Saturday October 24, 2015

Excellus BCBS to offer new health plan for $0 or $20 a month

Plan designed to help those who don't qualify for Medicaid

    Excellus BlueCross BlueShield in 2016 will offer a new health plan with monthly premiums of zero or $20 a month.

    This new Essential Plan is subsidized by New York state and will only be sold to eligible individuals on the NY State of Health marketplace. Each of the Essential Plans offered by the different health insurers will have the same premiums with similar benefits.

    "The new Essential Plan is for individuals who don't qualify for Medicaid and don't have access to affordable health coverage," said Lynne Scalzo, vice president of business strategy and administration, Excellus BlueCross BlueShield. "Our goal is to inform eligible individuals that they might be able to purchase affordable health coverage, possibly for the first time."

    Individuals will qualify for the Essential Plan based on household size and income.

    Households at or below 150 percent of the federal poverty level ($17,655 for a household of one; $36,375 for a household of four) will not pay a monthly premium for the plan.

    Households between 151 percent and 200 percent of the federal poverty level ($23,540 for a household of one; $48,500 for a household of four) will pay a monthly premium of $20 for each adult.

    Individuals will have access to low-cost coverage and valuable benefits, including:

    • Access to a wide selection of doctors and hospitals

    • Routine preventive care checkups, screenings and immunizations for no copayment

    • No deductible

    • Prescription drug coverage

    • $400 a year toward a fitness facility or individual fitness class reimbursement

    The federal penalty for going without health insurance will increase in 2016. The penalty in 2016 will be $695 per person, or 2.5 percent of your household income, whichever is greater.

    "For those who qualify for an Essential Plan, you can now purchase health insurance for $0 or $20 a month and avoid the financial penalty," Scalzo said. "The Essential Plan might be a good option for young adults purchasing health insurance for the first time." NY State of Health will send individuals currently enrolled in the marketplace information about renewing their coverage for 2016.

    Eligible individuals who are not currently enrolled in a plan on the marketplace can purchase an Essential Plan for 2016 when the open enrollment period begins on Nov. 1.

    The Affordable Care Act gave states the option to establish affordable plans for lower-income individuals who earn too much to qualify for Medicaid. New York state chose to offer these plans — called Essential Plans — starting Jan. 1, 2016.