The Patient Protection and Affordable Care Law of 2010, amended by the Health Care and Education Reconciliation Act of 2010, are referred to collectively as the “Affordable Care Act.” Today, we will refer to it as the “Health Care Law.”
What is the Health Insurance Marketplace?
The Health Insurance Marketplace is a new way to find and buy health insurance, apply for Medicaid and the Children’s Health Insurance Program (CHIP). The Marketplace is designed to help you find health coverage that fits your budget, with less hassle. Qualified individuals and employers can shop for affordable, private coverage from Qualified Health Plans.
What are Qualified Health Plans in the Marketplace?
Qualified Health Plan will cover a core set of benefits called Essential Health Benefits. New and expanded programs will be directly linked. You will have guaranteed coverage and renewability, regardless of a pre-existing condition (like cancer or diabetes), sex, age, etc. Qualified Health Plans in the new Marketplace will be sold and run by private companies and insurance agents.
What are the Key Features of the new law?
- ENDS PRE-EXISTING CONDITION EXCLUSIONS FOR CHILDREN: No limit or denied benefits / children under 19 due to pre-existing conditions.
- KEEPS YOUNG ADULTS COVERED: If you are under 26, you may be eligible under your parent’s health plan.
- ENDS ARBITRARY WITHDRAWAL OF YOUR INSURANCE COVERAGE: Insurers can no longer cancel your coverage because of an honest mistake.
- INDIVIDUALS AND FAMILIES ARE GUARANTEED COVERAGE FOR PRE-EXISTING CONDITIONS: Insurers can no longer be denied or charged more because of gender, weight, or health status.
What are the changes in costs?
AGE: BROKEN DOWN INTO 3 CATEGORIES *Except VT, NY
► 21 Years old: Rating factor=1.0 This means they are the reference point
► 49 years old: Rating factor =3.0 This means they will pay up to 1.7 times as much as a 21-year –old
► 65+ years old: Rating factor =3.0 This means they will pay up to 3 times as much as a 21-year-old+
GEOGRAPHIC LOCATION
► Determines which insurance system you will go through. Same choices, just different systems.
► Federally Facilitated Marketplaces
► State Based Marketplaces and
► Partnership Marketplaces
MAJOR CHANGES IN COVERAGE
Don’t get caught with your pants down, it’s not worth it. Having no medical coverage can cost more than a penalty, it could cost a life. The purpose of the new law is to protect everyone in the country from astronomical medical bills, should the need arise. It is also an attempt to stop insurance companies from escalating premiums in the future.
Specific health care benefits may vary by state.
Even within the same state, there can be small differences between health insurance plans. When you fill out your application and compare plans, you’ll see the specific health care benefits of each plan.
Get in touch with a Access Medical sales rep to get more information
No matter which metal category you choose, you can save a lot of money on your monthly premium based on your income.
Your premium can be lower, based on your income
When you fill out a Marketplace insurance application, you’ll find out if you qualify for these savings. Learn how you can save on your monthly insurance bill with a premium tax credit..
