Q: I am 23, live in Sarasota, and make $8.98 an hour at a 30-hour-a-week job. What health benefits are available for me? — Janet from Sarasota
A: You are what the federal government calls a “young invincible.” You’re young and likely relatively healthy. And a lot of your peers would rather spend their money on things other than health insurance. The government really wants you to sign up because your health care costs are relatively low.
Based on the income information you provided, you earn just $270 a week, or $13,500 a year if you work 50 weeks. That’s just 117 percent of the Federal Poverty Level, which makes you eligible for significant discounts on a monthly premium on the Health Insurance Marketplace.
According to the Kaiser Family Foundation’s subsidy calculator (check it out on our special report page: www.tbo.com/healthcare-act/) you would be asked to pay $270 for the year to have insurance. Extras, such as co-pays for doctor visits or additional treatments, aren’t included in that monthly premium. The government, according to the subsidy calculator, would cover most of the total annual premium of $2,535.
But there’s a big what-if in this scenario. If you use tobacco, you could be charged up to 50 percent more of the total premium, which could be as much as $1,250 for the year. That tobacco penalty could be a game changer for you or others who smoke.
Also, because you are younger than 30, you would be eligible for what’s called catastrophic coverage. This reduced-benefits plan requires you to cover all of your medical costs up to a certain amount, with the exception of just three primary doctor visits a year. While the monthly premium for a catastrophic plan is lower than other options, it’s important to know that any discounts or subsidies you may get on other marketplace plans can’t be used here.
Floridians in your situation are not eligible for Medicaid, a government-backed insurance for the poor. Some states have expanded the income requirements for this program, but not the Sunshine State. Keep an eye on that issue, as legislators could consider it again.