The Affordable Care Act: What Does it All Mean?

on Oct 4, 2013 in General Parrott Insurance News

The Affordable Care Act: What Does it All Mean?

Healthcare is always a hot button issue in political debates and the national news. Lately, a media storm has been brewing over the Affordable Care Act (ACA) – also known widely as the Health Reform Law or Obamacare. That’s because the law is about to significantly change the way health insurance works by making it available and affordable to more people.

What is the Affordable Care Act?
The ACA is a federal statute that was signed into law by President Barak Obama on March 23, 2010. It is the most significant overhaul to our health care system in about 50 years. The goal of the law is to increase affordability and access to health care. The ACA does not replace Medicaid, Medicare, or private insurance. If you have health coverage you like, you can keep it, in most cases.

How do people gain access to ACA Insurance?
In North Carolina, the federal government has created a new web site that allows you to buy and compare health plans side-by-side from competing private health insurance companies. The marketplace will determine if an individual or family is eligible for a policy and the cost per month. This web site is often called “the exchange” or marketplace. And, good news! Your local agent, such as folks at our office – Parrott Insurance – can help you through this confusing process and it does not cost you any more than applying on your own.

When can I shop?
The Marketplace is not open all the time. In 2013, it opens on October 1st and closes March 31st, 2014. This is called the Annual Enrollment Period (AEP). There will be one AEP each year. If you miss it, you can’t purchase health coverage unless you have a qualifying event – like moving to a different state, adding a newborn to your plan, losing your insurance through your job, etc.

How does it increase Affordability?
The federal government will offer to subsidize the cost of health insurance for some people. Americans making less than 400% of the poverty level – approximately $45,960 for an individual or $94,200 for a family of 4, may be eligible for a subsidy. Some subsidies could cover the full cost of your premium so you will pay $0 for your health insurance. In fact, it’s estimated that millions across America will pay less that $100 per month for their insurance, according to a Department of Health and Human Services report released Sept 17, 2013.
The subsidy covers the full or partial cost of your insurance premium and is paid directly to the company that provides your insurance. That way, you’re not stuck with a big bill waiting for reimbursement. And, the less money you make, the more federal dollars you get towards your health plan.
However, not all people will be able to get a subsidy for their health insurance. People who are able to get qualified health insurance from their employer will not be able to receive a subsidy for health insurance bought on the exchange.

I can’t get insurance because of a health condition…NOT ANYMORE!
The Affordable Care Act includes many protections for Americans. One of those protections ensures that health coverage cannot be denied to anyone, including those with pre-existing health conditions. In addition, insurers may not drop individuals when they become sick. The Act also says men and women will pay the same price and stops insurers from placing lifetime and annual limits on coverage. However, costs will still be affected by age, location, and tobacco use.

What do the policies cover?
The ACA intends to give access to affordable, quality health insurance to everyone. As such, the ACA requires all health plans to contain certain services called Essential Health Benefits (EHB).
Furthermore, the ACA requires health insurers to provide access to preventive health services with no cost sharing. So your annual physical at your primary care doctor could cost you $0.

What does this mean for me and my family?
Part of the ACA requires most Americans to obtain health coverage by January 1st, 2014, receive an exemption, or pay a fee for being uninsured.
We know that this law is broad and confusing. It also affects all of us in different ways. We’re sure that you have questions, and we are happy to help.
Attend an informational session at 10am, 2pm or 4pm any week day at our office at 150 Weaver Drive in Lexington.

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