What you need to know about the Affordable Care Act
Healthcare is Changing – What you need to know about the Affordable Care Act
On March 23, 2010, President Obama signed into law the Affordable Care Act (ACA). The ACA allows access to health insurance options through a Health Insurance Marketplace. Open enrollment for the Health Insurance Marketplace begins on October 1, 2013.
Here are answers to some frequently asked questions about the new Healthcare Reform Law.
What is the Affordable Care Act?
The Affordable Care Act (ACA) is a bill passed by the government in 2010 that is changing the way our healthcare system works.
What are the benefits that the ACA brings to the U.S. healthcare landscape?
The ACA brings enhancements to the way that the healthcare systems works. Some of the main benefits:
- Coverage for those with pre-existing conditions
- No lifetime limits
- Kids can stay on a parent's healthcare plan until they are 26 years old. Some states may increase this age limit.
- Yearly checkups are covered. Many preventive services are also covered - such as blood pressure tests, shots and some cancer screenings.
What does the ACA mean for most people's health insurance coverage?
Before the ACA was passed, you were not required to have health insurance. Starting on January 1, 2014, most people will need to have insurance coverage either through their employer, through Medicaid or Medicare, or they will need to buy health insurance. If you choose not to have health insurance coverage, you may be subject to a fine, in the form of a tax penalty. The penalty is relatively small in 2014, but becomes larger in 2015 and 2016.
What is a Health Insurance Marketplace (also known as an Exchange)?
Every state will have a marketplace in which a consumer can shop for health insurance. These are called Health Insurance Marketplaces, also known as Health Exchanges. Consumers will be able to shop, compare and select the health plan which best suits their needs. The Health Insurance Marketplaces will allow consumers to do their shopping online, in-person, over the phone, or by mail. Consumers will be able to look at information such as the provider network, benefits, premiums, deductibles, co-pays, and co-insurance aspects of a health plan before selecting a plan.
Who can buy a plan on a Health Insurance Marketplace?
Anyone will be able to search online for a healthcare plan in their state Health Insurance Marketplace. The requirements to get insurance through the Marketplace are:
- Meet applicable state residency requirements
- You must be a U.S. citizen, national, or noncitizen who is lawfully present
- You cannot be currently incarcerated
What is a subsidy?
In some cases, the government may help pay some of an individual or family's monthly premium for health insurance purchased in a Health Insurance Marketplace (or Exchange). This is called a subsidy (or Advanced Premium Tax Credit, APTC). The amount of the subsidy depends on several factors, including:
- Family income
- The size of the family
- How these factors relate to federal poverty guidelines
- The cost of health plans available in the Health Insurance Marketplace
In general, people and/or their families whose income is under 400% of the Federal Poverty Level (FPL) may receive a subsidy to lower their monthly premiums. The subsidy will be higher for those under or near 100% of the Federal Poverty Level, and the subsidy will decrease for those with income closer to 400% of the FPL.
Those individuals and/or families under 400% of the Federal Poverty Level may also be eligible have their deductibles and out-of-pocket expenses reduced. These are known as cost-sharing reductions.
If someone doesn't receive a subsidy due to income status, they are still able to shop for a health plan on the Health Insurance Marketplaces.
What is the Federal Poverty Level (FPL)?
This is the measure of income level issued annually by the Department of Health and Human Services. These levels are used to determine eligibility for certain programs and benefits. For 2012, the federal poverty level for a family of four is $23,550.
What is the timetable for the launch of Health Insurance Marketplaces?
This year, open enrollment on the Healthcare Insurance Marketplaces begins on October 1, 2013 and goes until March 31, 2014. Healthcare coverage can begin as early as January 1, 2014. Following this initial enrollment period, open enrollment period will typically be every fall, from October 15th to December 7th.
To find out more log onto www.Healthcare.gov website