In order to get a better sense of how premiums, deductibles, co-insurance, copayments, and out-of-pocket maximums come together for different health insurance options, this assignment will walk you through various scenarios of choosing a health plan in the new Health Insurance Marketplace implemented in 2014 as a result of the ACA. Please complete the assignment before our class on October 4th and bring a hard copy with you to class. You will need to refer to this during our class discussion and hand in the assignment in at the end of class.
Go to https://www.healthcare.gov/see-plans to access the federal Health Insurance Marketplace website.
You do not need to enter your email address.
For each of the following scenarios, think about what it would be like to be the person in the scenario with the expected income and make a plan selection based on what you think would be the best plan for you. Record your information on the table provided.
Georgia Scenario 1:
Zip code = 30302; Select ‘Fulton County’
Indicate that you are the only person in your household
Person #1 age = 27; select male or female; leave ‘other information’ blank
Select ‘continue’ to confirm household members
2018 expected household income = $500
Is this person eligible for a premium tax credit or other savings?
Select ‘skip’ when asked to indicate what level of medical care you anticipate using this year
Select ‘skip’ when asked to enter information about your doctors, medical facilities and prescription drugs
Select ‘continue to plans’ or ‘skip to plan results’ on next page and select ‘see all plans’
Which plan would you choose? (You must select a plan.)
Why? (Just a few sentences about what was most important in your decision.)
Georgia Scenario 2:
(Same as Scenario 1 except expected income = $12,000)
Zip code = 30302; Select ‘Fulton County’
Indicate that you are the only person in your household
Person #1 age = 27; select male or female; leave ‘other information’ blank
Select ‘continue’ to confirm household members
2018 expected household income = $12,000
Is this person eligible for a premium tax credit or other savings?
Select ‘skip’ when asked to indicate what level of medical care you anticipate using this year
Select ‘skip’ when asked to enter information about your doctors, medical facilities and prescription drugs
Select ‘continue to plans’ or ‘skip to plan results’ on next page and select ‘see all plans’
Which plan would you choose? (You must select a plan.)
Why? (Just a short sentences about what was most important in your decision.)
Georgia Scenario 3:
(Same as Scenario 1 except expected income = $28,000)
Zip code = 30302; Select ‘Fulton County’
Indicate that you are the only person in your household
Person #1 age = 27; select male or female; leave ‘other information’ blank
Select ‘continue’ to confirm household members
2018 expected household income = $50,000
Is this person eligible for a premium tax credit or other savings?
Select ‘skip’ when asked to indicate what level of medical care you anticipate using this year
Select ‘skip’ when asked to enter information about your doctors, medical facilities and prescription drugs
Select ‘continue to plans’ or ‘skip to plan results’ on next page and select ‘see all plans’
Which plan would you choose? (You must select a plan.)
Why? (Just a short few sentences about what was most important in your decision.)
Repeat these three scenarios for California, a state that has a state-based marketplace exchange and has expanded Medicaid. Use the same scenarios as above except change the state.
Go to http://www.coveredca.com/
Under the ‘Shop and Compare’ tab, select ‘Shop and Compare Tool’
Enter the household income ($500; $12,000; $28,000), zip code for San Francisco (94134) and age (27)
Under the “Breaking Down the Monthly Cost” section:
If the result is that you are eligible for Medicaid in that state (in California, called Medi-Cal, just put Medicaid in the “Plan” column and leave the remaining columns blank. (Do not navigate to the state’s Medicaid enrollment.)
If the result is that you qualify for health insurance through “Covered California”, select ‘See My Options’ and navigate through the various options (Bronze/Silver, Gold/Platinum and Minimum Coverage) before selecting one. Select ‘View Details’ and ‘View Plan Benefits’ on the next page to see specific information needed to complete the table.
Which plan would you choose? (You must select a plan.)
Why? (Just a short few sentences about what was most important in your decision.)
Name(s):
GA Scenarios Eligible for tax credits/ other savings? Plan chosen Why chosen? Premium Deductible Out-of-pocket max Primary care visit Specialist visit Generic prescription ER visit
GA scenario 1: 27, $500
GA scenario 2: 27, $12,000
GA scenario 4: 27, $28,000
CA Scenarios: Eligible for tax credits/ other savings? Plan chosen Why chosen? Premium Deductible Out-of-pocket max Primary care visit Specialist visit Generic prescription ER visit
CA Scenario 1: 27, $500
CA Scenario 2: 27, $12,000
CA Scenario 4: 27, $28,000
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