OBAMACARE - The Affordable Health Care Act (ACA)

Q. What is Obamacare?

Obamacare's goal is to give more Americans access to affordable, quality health insurance, and to reduce the growth in health care spending in the U.S. The Affordable Care Act expands the affordability, quality, and availability of private and public health insurance through consumer protections, regulations, subsidies, taxes, insurance exchanges, and other reforms. Obamacare offers a number of new benefits, rights and protections including provisions that let young adults stay on their plan until 26, stop insurance companies from dropping you when you are sick or if you make an honest mistake on your application, prevent against gender discrimination, stop insurance companies from making unjustified rate hikes, do away with life-time and annual limits, give you the right to a rapid appeal of insurance company decisions, expand coverage to tens of millions, subsidize health insurance costs, require all insurers to cover people with pre-existing conditions, among other things. Obamacare's new benefits, rights and protections also include the requirement that most non-grandfathered health insurance plans cover preventive services and provide at least ten new essential health benefits. Learn more about grandfathered health plans. Ten essential health benefits including emergency care, hospitalization, prescription drugs, maternity, and newborn care must be included on all non-grandfathered plans with no annual or lifetime dollar limits. Free preventive services including yearly check-ups, immunizations, counseling, and screenings must be included on all non-grandfathered plans at no out-of-pocket costs.

Q. How to take advantage of Obamacare?

Obamacare's official health insurance marketplace is healthcare.gov. Marketplace insurance must be obtained during open enrollment, you won't be able to get marketplace coverage outside of open enrollment without qualifying for a special enrollment period. Open enrollment starts in November of each year and ends in December of the same year. If you miss the annual open enrollment period, you may still have options. Individuals may qualify for special enrollment period outside of open enrollment if they experience certain qualifying life events.

Q. Who has benefitted from Obamacare?

Over 100 million Americans have already benefited from the new health care law. This includes more than 105 million people who accessed critical preventive services for free that had previously been subject to out-of-pocket costs, billions of dollars saved for seniors from the gradual closing of the Medicare Part D "Donut Hole", billions saved from new accountability measures for insurance companies, and much more.

Q. What is available on the Obamacare Marketplace?

There are 4 types of Qualified Health Plans (sometimes called metal plans) available on the marketplace. Each one has the same basic benefits, rights and protections, but different networks and cost-sharing. As a rule of thumb the more "valuable" the metal the higher the premium and lower the out-of-pocket costs. Aside from the 4 basic "metal" health plan types, a "catastrophic" health plan is available through the health insurance marketplace for people under 30 and people with hardship exemptions. Catastrophic health plans tend to have a low premium but very high out-of-pocket costs.

1. Bronze Plan: You pay 40% the plan pays 60%.

2. Silver Plan: You pay 30% the plan pays 70%.

3. Gold Plan: You pay 20% the plan pays 80%.

4. Platinum Plan: You pay 10% the plan pays 90%.

Q. BTW, How does Health Insurance work?

You pay a premium for every month you have coverage. The higher the premium the less out-of-pocket expenses you are responsible for and the larger network of doctors and providers you can utilize. All plans starting in 2015 are required to offer some basic benefits, rights and protections but difference out-of-pocket costs. & Remember, you don't have coverage officially until your premium is paid!

Q. How do I get started?

Give us a call today to learn more.

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Obamacare enrollment starts November 1st.