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Posted: Friday, September 27, 2013 12:45 pm | Updated: 7:35 pm, Fri Sep 27, 2013.

Few things have come along in recent history that have sparked more questions than the Affordable Care Act, better known as Obamacare. To help inform your decision-making with MNsure’s implementation, starting Oct. 1, here are some of the more common questions about the exchange and the answers you’re looking for.

Q: What is MNsure?

A: MNsure, is the state’s new online health insurance marketplace, sometimes called an exchange. Minnesota consumers and small businesses with up to 50 full-time employees will be able to obtain health insurance through MNsure. Options will range from free or low-cost policies for government health insurance such as Medicaid and MinnesotaCare to commercial health plans.

{span}Q: How does MNsure affect me?{/span}

{span}A: {/span}{span}Minnesotans who have health insurance through a large employer won’t be using MNsure. {/span}{span}MNsure’s primary constituencies include people shopping for individual, family, or small business coverage. People who’ve bought such plans through an insurance agent or broker can continue to use an agent. But federal subsidies are only available if your agent or broker is registered to sell on MNsure. {/span}{span}People buying on their own using MNsure can get subsidies if they’re eligible. {/span}{span}MNsure will also serve as the entry point for enrolling in two government insurance programs: Medical Assistance (Minnesota’s Medicaid program) and MinnesotaCare.{/span} {span}MNsure does not affect people enrolled in Medicare, the government insurance program for elderly Americans.{/span}

Q: How does MNsure work?

A: {span}The website goes live Oct 1 and is designed to offer one-stop shopping for insurance. After entering income and other basic information Minnesotans will be routed either to government insurance programs — if their income qualifies — or to commercial plans. {/span}{span}MNsure will allow side-by-side comparisons of commercial plans offered by different companies or with differing levels of coverage. MNsure will also let you know if you qualify for tax credits, or other financial help. {/span}

{span}Q: How do I apply?{/span}

{span}A: Go to the MNsure website http://mnsure.org and the system will guide you through enrollment step-by-step starting Oct. 1.{/span}

{span}Q: Is there help to figure this out?{/span}

{span}A: {/span}{span}MNsure toll-free call-center 1-855-3-MNSURE, or 1-855-366-7873. Operators are available to answer questions in English, Spanish, Hmong and Somali. Callers will also have access to interpreter services in at least 140 other languages. {/span}{span}The call center is open Monday through Friday, 7:30 a.m. to 8 p.m., and on Saturdays from 9 a.m. to 4:30 p.m., during the open enrollment period, which ends March 31, 2014. {/span}{span}The state is also providing “navigators” and “in-person assisters” to help Minnesotans enroll in the health plans sold on MNsure. They’ll provide education, impartial information and assistance signing up.{/span}{span} {/span}{span}Licensed insurance agents and brokers who complete a MNsure training course will also be able to assist consumers seeking insurance on the marketplace. {/span}

{span}Q: How much will I have to pay for insurance?{/span}

{span}A: {/span}{span}That depends largely on how much you want to pay in premiums and whether you qualify for income-based tax credits. The least expensive option on MNsure is available to a 25-year-old non-smoker living in the Twin Cities. {/span}{span}The plan carries a premium of about $91 a month. Someone who qualifies for tax subsidies would pay even less. Premium rates, though, will vary by region, age, and whether you smoke.{/span}

{span}Q: I own a small business. How does MNsure affect me?{/span}

{span}A: {/span}{span}If your business employs fewer than 50 full-time employees, you don’t have to provide health insurance under the health care law. {/span}{span}In addition, some small businesses may be eligible for tax credits, depending on the number of employees, average wages, and the employer’s contribution towards health insurance. {/span}{span}Go to this site for a small business cost calculator: {/span}http://mn.gov/hix/calculators/BusinessCalculator.jsp

Q: What if I have no insurance and I do nothing?

A: {span}Unless you are a member of one of the groups that’s exempt from the Affordable Care Act’s mandate to obtain health insurance, you will be subject to a $95 fine or 1 percent of your taxable income, whichever is greater starting next year. The fine increases substantially in subsequent years. {/span}{span}Those exempt from the mandate include certain religious groups; American Indian tribe members; people who don’t earn enough income to file a tax return; and people who’d have to pay more than 8 percent of their income for health insurance, after taking account of any employer contributions or tax credits.{/span}

Q: What if I have insurance, do I need to pay attention to MNsure?

A: {span}That depends on what kind of insurance you have and if you’re eligible for tax credits.{/span}

Probably not, if you get your insurance through a large employer or your current insurance meets minimum essential coverage under the health care law, which may even include “bare bones” plans.

{span}Yes, if you have insurance now that covers a specific disease or illness only, you will have to get new insurance because these plans don’t meet minimum requirements under the Affordable Care Act.{/span}

Yes, if you buy an individual or family plan or coverage for a small business with fewer than 25 employees and want to seek federal premium subsidies. These are only available for people who buy on MNsure themselves or through an agent or broker registered to sell on MNsure.

No, if you’re on Medicare.

{span}Q: If I use MNsure, can I keep my doctor?{/span}

{span}A: {/span}{span}If you buy health insurance as an individual or for your family, it’s possible you might not find a plan that includes your current doctor; it depends on the plan you choose and whether your doctor is part of the insurer’s provider network.{/span} {span}If you currently obtain health insurance through work, and your employer stays with the same plan, you won’t have to change doctors. But as always, employers can change plans regardless of the the impact of the health care law. If your employer switches plans, your network of doctors and clinics may also change, whether or not the new plan is one offered on MNsure.{/span}

{span}Q: If I qualify for tax credits on MNsure, when do I receive that subsidy? Do I have to wait for it to come the following year as a tax refund?{/span}

{span}A: You get it immediately as a discount on your premium. So if the plan is a $1,000 and you get a $500 tax credit, you only have to pay $500.{/span}

{span}Q: If my employer offers insurance, but it’s too expensive for my budget, can I buy a plan on MNsure?{/span}

{span}A: {/span}{span}Any Minnesota resident can buy insurance on MNsure whether or not your employer offers coverage. But for people who choose MNsure over a workplace plan, there’s a relatively high bar to qualify for federal subsidies that bring down the cost of buying insurance on your own. {/span}{span}An employer’s plan would have to eat up more than 9.5 percent of your household income. If your employer coverage costs less than 9.5 percent of your household income, you could still buy insurance on MNsure but couldn’t take advantage of the law’s tax subsidies. {/span}{span}For the state’s median household income of $58,476, 9.5 percent amounts to about $463 per month.{/span}

{span}Q: What are these “metal” levels of individual and small group insurance plans — bronze, silver, gold and platinum?{/span}

{span}A: {/span}{span}Comparing health insurance policies is complicated because the coverage can vary so widely from one plan to another.{/span} {span}The federal health care law divides health plans to be sold on health insurance exchanges such as MNsure into four categories, named after metals: bronze, silver, gold, and platinum — the more precious the metal, the more generous the plan on average — and the higher the premiums.{/span}

The tradeoff is this: the higher the premiums and the more extensive the coverage, the lower the out-of-pocket costs such as deductibles and co-pays.

Bronze plan: Will pay about 60 percent of the cost of the plan’s benefits; the consumer pays the rest in deductibles, copays and coinsurance.

Silver plan: Will pay about 70 percent of the enrollees’ health care costs on average; the consumer is responsible for the remaining 30 percent.

Gold plan: Will pay about 80 percent of the costs; the consumer is responsible for the remaining 20 percent.

Platinum plan: Will pay about 90 percent of the costs; the consumer is responsible for the remaining 10 percent.

Source: Minnesota Public Radio and MNsure

© 2015 Southernminn.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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