MNsure: Minnesota's Health Insurance Marketplace

1. About MNsureMinnesota’s health insurance marketplace Name of event Date of event Presenter name and title

2. What is MNsure? • A marketplace where Minnesotans can find, compare choose and get quality health care coverage that best fits your needs and budget • The place to see if you qualify for financial help, including tax credits, Medical Assistance and MinnesotaCare

3. What MNsureis NOT • An insurance company • A health plan • Just a website • Only for those who qualify for a public program or make a certain amount of money

4. Who Does MNsure Serve? • Individuals & families • Uninsured consumers • Self-employed consumers and others who need to purchase health coverage on their own rather than through an employer • Consumers seeking tax credits to help cover the cost of premiums • Those seeking Medical Assistance (MA) or MinnesotaCare

5. What MNsure Offers • Choice: One-stop shopping with a broad range of plans from multiple insurance companies. • Financial help: MNsure is the only place to see if you qualify for low-cost or no-cost coverage, or tax credits to help pay your insurance premium. • Streamlined application: You only need to fill out one application for you and your family for all coverage options in MNsure. • Free, local in-person enrollment help across the state.

6. Consumer Protections • Individuals can no longer be denied coverage or be charged a higher premium for coverage because of their medical history. • There are no annual or lifetime benefit limits on coverage. • There are no exclusions or waiting periods on medical plans for individuals with pre-existing health conditions.

7. Essential Health Benefits All plans cover: • Hospitalizations • Outpatient services and doctor’s office visits • Rehabilitative and habilitative services and devices • Emergency services • Prescription drugs • Laboratory services • Maternity and newborn care • Children’s dental and vision care • Mental and behavioral health services

8. Preventive Services • No co-pays or co-insurance for: • Screenings such as blood pressure, cholesterol and diabetes • Cancer screenings such as mammograms & colonoscopies • Vaccinations and flu shots

9. American Indian Benefits American Indians or those who qualify to use IHS or Tribal Health Services can expect: • Consistent care. Can continue to get care from IHS, Tribal or Urban Indian Healthcare Facility. • No cost-sharing. Won’t pay for any service from an IHS, Tribal or Urban Indian Healthcare Facility. May also qualify for reduced cost-sharing at any doctor/provider depending on income. • Tribal sponsorship. Some Minnesota tribes will pay insurance premiums. American Indians are: • Entitled to change health plans once a month, if desired. • Exempt from the federal mandate requiring all individuals to purchase health insurance. • Exempt from federal tax penalties for not having coverage.

10. Tax Credits • Only through MNsure can you qualify for a tax credit that can lower your monthly premium. • Individuals making up to $49,960 (in 2020) • Families of four making up to $103,000(in 2020)

11. Cost-Sharing Reductions • People within 200-250% of the federal poverty level will get support to pay co-pays, deductibles and/orco-insurance • Individuals earning up to $31,225 (in 2020) • Families of four earning up to $64,375 (in 2020) • Everyone who buys coverage through MNsure has a cap on their total out-of-pocket spending (includes deductibles, co-pays, co-insurance) for covered services offered by in-network providers • Maximum for individual coverage in 2020 is $8,200 • Maximum for family coverage in 2020 is $16,400 • Some plans offer lower out-of-pocket maximum costs

12. Medical Assistance (MA) and MinnesotaCare • Find out if you qualify through MNsure • One application determines your eligibility for public programs or tax credits • Income-based eligibility • Depending on income, coverage is either no-cost or low-cost • Benefits are comparable to private insurance and include other services (such as transportation)

13. Medical Assistance (MA) • Minnesota’s Medicaid program • Covers many people with low incomes, especially children and pregnant women • No monthly premium; low co-pays for some services • No asset test • Eligible individuals can enroll at anytime

14. MinnesotaCare • For Minnesotans with lower incomes who don’t have access to affordable employer health care coverage and are not eligible for Medical Assistance (MA) • Individuals who have access to affordable employer-sponsored insurance may not be eligible • Maximum premium is up to $80/month per person • No asset test • Eligible individuals can enroll year-round • No premiums for American Indians and Alaska Natives and their household members

15. What You Pay • Factors that affect health plan premiums: • If you are an individual or family • Where you live • Your age • Whether you use tobacco

16. What You Pay (cont.) The financial help you may qualify for depends on household size and annual income(table below is for 2020 open enrollment)

17. Health Plans • Insurance companies with individual/family plans: • Blue Plus • HealthPartners • Medica • UCare

18. Simple Steps to Get Covered * If you qualify for Medical Assistance or MinnesotaCare, you do not need to go to step 3. The plan options available will be mailed to you. ** If you qualify for Medical Assistance, you will not pay a premium. MinnesotaCare premiums are paid through the MN Department of Human Services.

19. Plan Comparison Tool • Easy way to compare and choose the right medical insurance plan to fit needs and budget • Get more complete picture of health costs • Find the plans available compared on total estimated cost (not just premiums or deductibles) • Find out if you can get help paying for coverage

20. Get Help: Contact Center 651-539-2099 (855-366-7873 outside the Twin Cities) • Hours • During open enrollment: • Monday – Friday, 8 a.m. – 5 p.m. (Thursday until 7 p.m.); Saturday 10 a.m. – 2 p.m. • Outside of open enrollment: • Monday – Friday, 8 a.m. –4 p.m. • Staff fluent in Spanish, Hmong and Somali • Access to interpreter services for more than 140 languages https://www.MNsure.org/help/

21. Get Help: In Your Community Free in-person help when you need it • Navigators: trained individuals at trusted community organizations, provide free assistance with filling out an application and enrolling in coverage, can help consumers understand health plan options but cannot recommend plans • Agents/Brokers: licensed by the Minnesota Department of Commerce, compensated by insurance companies, can provide advice as to which insurance plan is best for an individual’s situation • Certified Application Counselors: trained staff at hospitals, community health centers and clinics • Assister Directory: Go to MNsure.org and search “free help” • Search by type, language, city, county, zip code or agency name

22. Find an Assister

23. When to Enroll • Open enrollment for individuals and families in qualified health plans is November 1-December 23, 2019 • To apply for a qualified health plan outside of open enrollment, you must have a life event that qualifies you for a special enrollment period • Individuals who are eligible for Medical Assistance or MinnesotaCare may enroll throughout the year • Members of federally recognized tribes may enroll or change plan designations one time per month

24. Special Enrollment Period • Life events that may qualify for special enrollment include: • Adoption • Foster care • Birth of a child • Marriage, divorce • Gain of citizenship, national or lawfully present status • Loss of health insurance coverage • Newly eligible or ineligible for tax credits or for cost-sharing reductions (for those already enrolled through MNsure) • Permanent address change that provides new choices for qualified health plans • Enrolled member of a federally recognized tribe

25. Questions? MNsure.org Insert your photo here (optional)Remove this box if no photo Presenter name Title Email address Phone number