With summer almost over, it’s time to load up on school supplies and make sure your children are healthy and ready to focus on their studies. It’s important for kids to have a checkup before school starts – which may mean spending some time navigating health insurance.
Not understanding how to get or use health insurance can be a barrier to accessing regular, preventive medical and dental services. Over the years, health insurance has become full of complicated jargon – and often attached to a high monthly bill. Sifting through the insurance world can seem like it’s not worth the effort to get coverage and visit the doctor.
On the other hand, insurance companies are now required to offer a comprehensive list of preventive services at no cost to members. Covered preventive services include well-child checkups, immunizations, cancer screenings, family planning services, and much more.
In addition, the cost for a health plan is decreasing for many. In the past two years, approximately 85 percent of people who have signed up for insurance through Washington’s health-care exchange, Washington Healthplanfinder, have received financial assistance to lower their costs. Even families who have insurance through their employers are sometimes able to benefit from expanded coverage options.
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How can you learn about free or low-cost coverage options for which your family qualifies? It primarily depends on three factors: the number of people living in your household and/or you claim on your tax return, your household income, and whether you have the option to get health insurance through your job or your spouse’s job.
Once you have gathered that information, you can apply for health insurance on Washington Healthplanfinder, at www.wahealthplanfinder.org. For people who prefer to enroll or have questions answered in person, state-certified navigators and brokers are available to walk individuals through the process.
Washington Healthplanfinder takes information you provide about employer insurance options, household size, and income, and places each person into one of the following eligibility categories:
Washington Apple Health: A no-cost health insurance plan offered through our state’s Medicaid program. A family of four with a gross monthly household income of up to $2,789 can qualify for free insurance for their entire family. For those with higher incomes, Apple Health is free to children only at up to $4,244 in monthly income. If you do not have an option to add your children to an employer-based plan, you can earn up to $6,305 and purchase Washington Apple Health for your kids at only $30 per child per month. Washington Apple Health offers comprehensive insurance that even includes dental and vision (limited for adults).
Health Insurance Premium Tax Credits: Financial assistance from the federal government to lower the cost of your monthly payment, and sometimes deductibles as well. The tax credit is a set amount of money based on eligibility. With the money, you can purchase the least expensive plan on the Washington Healthplanfinder, a middle cost plan, or the most expensive plan, depending on your needs and budget. Let’s say, for example, that you received a tax credit of $150 per month. With that money, you could buy a $200 plan and pay only $50 out of your pocket per month, or you could buy a $250 plan and pay $100 per month.
Qualified Health Plan: If your family does not qualify for any financial assistance through Washington Healthplanfinder, you can still purchase a qualified health plan. Purchasing a plan through the Washington Healthplanfinder if you do not have other coverage will ensure that you have adequate coverage and will not be subject to a tax penalty when you file your next tax return.
At any time, you might experience a life event that affects your eligibility. As your circumstances change, you should report changes on your application and your eligibility will be redetermined so you are always given the appropriate amount of financial assistance.
Kristin Ely is outreach and enrollment supervisor at Interfaith Community Health Center.
Interfaith Community Health Center’s enrollment specialists offer free, unbiased, navigator services to the community at its Bellingham and Ferndale clinics. To learn more, call 360-788-2669 or go to www.wahealthplanfinder.org.