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Introduction to kynect Date. Objectives. Understand the importance of health coverage Understand basic components of kynect Describe new coverage options Describe insurance affordability programs Know how to become a Certified Application Counselor Organization. Importance of Coverage.
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Objectives • Understand the importance of health coverage • Understand basic components of kynect • Describe new coverage options • Describe insurance affordability programs • Know how to become a Certified Application Counselor Organization
Importance of Coverage • An unexpected illness or injury can happen to anyone • Drains financial resources • Personal bankruptcy in the U.S. • Peace of mind
Importance of coverage Health insurance = better access to care • People who DON’T HAVE health coverage are more likely to: • Skip getting medical care that they need • Postpone getting care due to cost • Not fill a prescription due to cost • Have trouble paying medical bills
Importance of coverage Health insurance = better access to care • People who DO have health coverage are more likely to: • Get preventive care that prevents illness • Get earlier treatment for illness or disease • Have better outcomes for health problems, because of early treatment
Importance of coverage • Approximately 694,000 uninsured in Kentucky • Drain on economy • Drain on provider resources
What is kynect? • Kentucky’s response to the ACA • State-Based Marketplace • One-stop-shop for insurance • Medicaid • KCHIP • Private Health Plans
Enrolling in kynect • One streamlined application for: • Qualified Health Plans – Insurance Affordability Programs • Medicaid • KCHIP • Apply: online, by phone, by mail or in-person • Open Enrollment through March 31, 2014
Expanded Medicaid • Kentucky expanded Medicaid eligibility • 133% FPL • 5% disregard • New populations covered
Qualified Health Plan • Is licensed and in good standing with the State of Kentucky • Meets other standards of the ACA • Covers Essential Health Benefits • Maternity and Newborn Care • Pediatric Care (including dental and vision) • Mental Health Care and Substance Abuse Treatment • Physical, Speech and Occupational Therapy • Doctor Visits • Hospitalization • Emergency Care • Prescriptions • Medical Tests • Wellness Visits
Insurance Affordability Programs • Two programs to help make insurance more affordable • Advanced Premium Tax Credits • Cost Sharing Reductions
Insurance Affordability Programs Advanced Premium Tax Credits (APTC) Cost Sharing Reductions (CSR) • New Federal program • Helps reduce out-of-pocket costs for enrollees in Silver QHPs. • Payments are made to issuers to reduce deductible and co-insurance (out-of-pocket) costs. • New Federal program that uses tax credits to reduce the premium cost for Qualified Health Plans (QHPs) • Can be applied directly to the premium • IRS reconciles over/under payment when people file taxes.
Where to get help • Kynect.ky.gov • Call Center: • 1-855-4kynect • In person Assistance • Insurance Agents • Kynectors • State-funded workers • Federally Qualified Health Centers • Other care providers