Many North Dakotans may not be aware the Affordable Care Act provides two ways to get financial help with their health insurance.
The federal tax credit on health insurance premiums has received most of the attention as a way to either reduce your monthly premium or take a new tax credit on your 2014 federal return.
But many North Dakotans may also be eligible for a break with their cost sharing amounts, as well. These subsidies are called cost sharing reductions and they lower the out-of-pocket expenses you are required to pay as part of your health plan.
Who is eligible?
Help is available for individuals and families who:
- Meet the criteria above. Your household income must be between 133 percent and 250 percent of the Federal Poverty Level.
- If you qualify for either of the subsidies—tax credits or cost sharing reductions—you need to get your coverage through the Health Insurance Marketplace. Blue Cross Blue Shield of North Dakota (BCBSND) plans are available through the Marketplace.
Choose a plan from the Silver plan category, such as BCBSND’s BlueCare 80 2500, BlueCare 70 3000, BlueDirect 80 2300 and BlueDirect 70 1400.
The Health Insurance Marketplace will determine if you are eligible for a subsidy. You can explore BCBSND plans and get to the Marketplace by starting at www.BCBSND.com/shop.
And if you’re a member of a federally recognized tribe, you may qualify for additional cost-sharing benefits.
Thanks to cost sharing reductions, you could pay lower out-of-pocket expenses when you use your health plan. For example, if your plan’s copayment for an office visit to your doctor is $50, the subsidy might reduce the copayment to only $20. The subsidy may also lower your deductible and/or coinsurance.
Cost sharing reductions are similar to getting a free upgrade on your health plan because your plan is covering a larger portion of your expenses.
Denise Pinkney is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.