The Affordable Care Act in Arizona

The Affordable Care Act in Arizona

Also Known As

Questions to ExploreQuestions to Explore

What are the aims of the ACA? How many more Arizonans are

covered? How does it work? What can Assisters and Brokers do? Where can I find help?

ACA – Triple AimACA – Triple Aim

Reduce number of uninsured

Reduce total healthcare expenses

Improve healthcare quality

Context

Results

Who is EligibleWho is Eligible

US Citizens

Lawfully Present

Deferred Action

Undocumented

Coverage – Four Important FactsCoverage – Four Important Facts

How It Works

Important Fact #1Important Fact #1

It’s Time

Health Insurance Marketplace Open Enrollment, Nov 1, 2015 to Jan 31, 2016

Special enrollment periods for life changes all year long; births, marriage etc.

AHCCCS (Medicaid) open year around

How It Works

For Jan 1 by Dec 15

Important Fact # 2Important Fact # 2

8 out of 10 received financial assistance

Received an average of $155 a month to lower monthly premiums

86 out of 100 could have bought a plan for less than $100 a month.

How It Works

Arizonans:

Important Fact # 2Important Fact # 2

Approximately 350,000 Arizonans are eligible

but not enrolled in free health care - AHCCCS

How It Works

Marketplace Financial

Assistance

AHCCCS

Making Insurance AffordableMaking Insurance Affordable

3. Premium Tax Credits

400% FPL

$79,160 (3 people)

250% FPL

$49,475 (3 people)

138% FPL$27,724 (3 people)

2. Cost Sharing Reduction

1. Medicaid

AHCCCS

How it Works

Making Insurance AffordableMaking Insurance Affordable

Family Size One Two Three Four Five

AHCCCS 138% $16,243 $21,983 $27,724 $33,465 $39,206

PTC & CSR 250% $29,425 $39,825 $50,225 $60,625 $71,025

PTC 400% $47,080 $63,720 $80,360 $97,000 $113,640

“The more you earn, the more you pay”

Marketplace Financial

Assistance

Example Example

Premium Tax Credits

How it Works

Monthly Insurance Premium for the Family $400

Premium Tax Creditgoes to Insurance Co. - $200

Your share $200

When you pay your income tax, you balance the books; take more than you should – must give it back;

take too little, get a check.

Marketplace Financial

Assistance

Example Example

• You pay for a Silver plan, but get a Gold plan.

• Your out-of-pocket costs to see a doctor, visit a hospital or get a prescription are less.

• Because you earn less, you get a reduction in your portion of the bill when you receive medical care.

Cost Sharing Reduction

How it Works

A Few Simple StepsA Few Simple Steps

Create an Account Apply Pick a Plan Enroll & Pay

Determination Notice$$ Financial Aid $$

How It Works

Get Covered or PayGet Covered or Pay

• $95 or 1% of income2014

• $325 or 2% of income2015

• $695 or 2.5% of income2016

“Whichever is greater”

How It Works

Options for shopping & enrollingOptions for shopping & enrolling

Do It Yourself healthcare.g

ov

1-800-318-2596 

BrokerAgent

1000’s to choose from

Assisters

One on one local help

$$ No charge to you – all are free $$

Statewide SchedulingStatewide Scheduling

Talk to a Navigator

844.790.4946Appointments

www.coveraz.org/connector

How It Works

Arizona’s largest primary care network; serving rural, urban and tribal areas

Comprehensive primary care, located in underserved areas, open to anyone with or without insurance coverage

Community Health Centers

700 E. Jefferson Street, Suite 100 Phoenix, AZ 85034 (602) 253-0090 www.aachc.org