The Kaiser Family Foundation (KFF) offered an online Estimate Tool For 2019 Health Care costs, helping individuals understand potential expenses and available financial assistance through the Health Insurance Marketplace. While the tool is no longer active for 2019 estimates, this article explores its key features and the information it provided. Understanding these elements can still provide valuable context for navigating health insurance options.
Key Features of the 2019 Health Care Estimate Tool
The KFF’s 2019 calculator aimed to provide estimates for:
- Potential Monthly Premiums: Users could input information like income, family size, and location to receive estimated costs for Bronze and Silver health insurance plans available through the Marketplace.
- Eligibility for Financial Assistance: The tool determined potential eligibility for premium tax credits and cost-sharing subsidies based on income and household information. These subsidies helped lower monthly premiums and out-of-pocket costs for eligible individuals and families.
- Medicaid Eligibility: The calculator also assessed potential Medicaid eligibility, a government program providing free or low-cost health coverage to those with limited income.
Factors Affecting Estimates
The 2019 estimate tool considered several factors impacting health insurance costs:
- Income and Family Size: Subsidy eligibility and amounts were primarily determined by income relative to the Federal Poverty Level (FPL) and household size.
- Geographic Location: Insurance premiums varied by location due to differences in cost of living, healthcare services, and market competition. The tool used location data to provide more accurate estimates.
- Age: While the Affordable Care Act (ACA) prohibited health status discrimination, age could impact premium costs in most states (exceptions included Vermont and New York). The ACA capped premiums for older adults at three times the cost for a 21-year-old.
- Tobacco Use: In many states, insurers could charge higher premiums for tobacco users, up to 50% more than non-users. The calculator, however, did not factor in tobacco use as surcharges varied significantly between plans.
Understanding Plan Types: Bronze and Silver
The calculator focused on Bronze and Silver plans, categorized by their actuarial value:
- Bronze Plans: Offered lower monthly premiums but higher out-of-pocket costs (deductibles, copayments) when utilizing healthcare services. Actuarial value around 60%.
- Silver Plans: Provided greater financial protection with moderate premiums and lower out-of-pocket costs than Bronze plans. Actuarial value around 70%. Silver plans served as the benchmark for calculating subsidy eligibility.
Limitations of the Estimate Tool
It’s crucial to understand that the 2019 tool provided estimates, not definitive results. Actual costs and subsidy amounts could differ due to:
- Data Accuracy: Reliance on user-provided information; potential discrepancies in income verification.
- Plan Availability: Plans shown might not be available in a specific zip code or county.
Conclusion
The KFF’s 2019 health care estimate tool offered a valuable resource for understanding potential insurance costs and financial assistance. While the tool itself is no longer applicable for 2019, understanding the factors considered—income, location, age, plan type—remains relevant for navigating health insurance choices. For current information and accurate cost estimates, consulting resources like HealthCare.gov is essential. Remember, understanding the basics of health insurance can empower informed decisions about coverage.
