1.Parents or single parents can add their adult children (up to age 26) to their plans.
2.If anyone in the household gets sick, the insurance company can’t drop them from the plan regardless of what it is.
3.If any children are chronically ill, a new insurance company can’t deny coverage regardless of health issue.
4.Most families will find that wellness or pregnancy exams are now free. In other words, they no longer have to make co-payments.
5.Insurance companies can’t raise premium payments without getting the OK from the state government.
6.Some families received a check from the insurance company. That’s because Obamacare says that companies must spend at least 80% of
premiums on providing actual medical services. If they spent it on advertising or executive salaries, they have to pay the excess back.
7.Open enrollment is the only time you can apply for cost assistance or change plans without qualifying for special enrollment. The amount of insurers offering plans through the marketplaces has increased by 25% this year. Make sure to compare plans during open enrollment 2015, even if you already have a qualified health plan.
8.Private insurance outside of the health insurance marketplace, Medicaid and CHIP don’t have open enrollment periods. The health insurance marketplaces, Medicare and employer based insurance all have unique open enrollment periods. Please be aware that although individual policies have no official open enrollment period, you won’t be able to get minimum essential coverage (major medical that protects you from the fee) in most cases as insurers have unofficially adopted the Affordable Care Act’s marketplaces enrollment periods
9.Cost sharing subsidies are only available on silver plans.
10. The official name for “ObamaCare” is the Patient Protection and Affordable Care Act (PPACA). It is also commonly referred to as Obama care, health care reform, or the Affordable Care Act (ACA)
What are insurance subsidies?
• Tax credits can be applied in part or in full in advance to lower your premiums or adjusted on your federal income taxes.
• If your income changes, report it so the marketplace can adjust your subsidies. You may qualify for bigger subsidies if your income decreases and you will save yourself from having to repay advanced tax credits if your income increases.
At anytime if you need help please call
If anyone can’t get insurance because of a pre-existing condition, Obamacare allows them to apply to the state to get temporary health insurance coverage until 2014. That’s when insurance companies can no longer deny coverage to adults.
People on Medicare – Obamacare allows seniors on Medicare to receive wellness and preventive care visits for free. See Medicare Preventive Services for the full list.
Those who are on Medicare Part D, which paid for some but not all the costs of prescription drugs, received $250 in 2010 if they needed it. In 2011, they received 50% off of brand-name prescription drugs, and a 7% discount for generic drugs. For more, see Drug Discounts. By 2020, Obamacare will pay 100% of prescription drug costs for those on Medicare Part D.
Those Who Earn $200,000 a Year or More – Taxes increased for individuals who earn $200,000 or more, and families who earn $250,000 or more. To find out more, see Obamacare Taxes.
Important Changes That Happen in 2014
Obamacare required everyone to enroll in health insurance by March 31, 2014. Those that didn’t are taxed about 1% of their 2014 income. Find out exactly how this affects you in How Much Will It Cost Me?
Anyone can still compare plans on the exchanges, which is a website run by their state or the Federal government. These exchanges also let people know when they qualify for tax credits. Obamacare is paying for most of the cost to operate these exchanges.
All health insurance plans must provide 10 essential health benefits. The only exceptions are plans that were in existence before March 23, 2010, and were “grandfathered in.”
Members and staff of Congress are required to get their insurance through the same exchanges, instead of the government-provided health insurance they got before. However, they continue to receive Federal subsidies to pay for their insurance: $4,900 for individuals and $10,000 for family coverage. For more, see When Does Obamacare Start?(Source: WSJ, Members Only, August 8, 2013; Affordable Care Act)
Families With Health Insurance – Many people with good health insurance are worried that their companies will cancel their existing plans. In fact, a government study said that this might happen to 3-5 million employees. Why? Some companies will find it cheaper to pay the penalties and allow their workers to get insurance on the exchanges. Most companies will keep offering health insurance as a benefit to attract the best workers. It’s actually less expensive for them than offering higher wages, because insurance isn’t taxed. (Source: CBO, The Effects of the Affordable Care Act on Employment-Based Health Insurance, March 15, 2012)
Families Without Health Insurance – Obamacare allows more people to get Medicaid. Anyone who makes less than $15,281 a year, or a family of four that makes less than $31,321.50 a year, can apply for Medicaid on the exchange. (Note: The eligible income is actually 133% of the Federal poverty level, so it will increase with inflation). The Federal government will pay all the additional cost for the first three years. After that, the states will pay 10%. Find out more about Medicaid.
Most families that make too much to get Medicaid will still get help. If their incomes are less than $45,960 for an individual, or $94,200 for a family of four, they can get tax credits every month or even reduced copayments and deductibles. (Note: This eligible income is 400% of the poverty level, and it will also increase with inflation).
Many indiviudals don’t think the Federal government should have the right to force people to get health insurance. Why is the Federal government requiring it? The thinking is that If everyone has health insurance, more people will go to the doctor when they are getting sick, instead of waiting for their illness to turn into an expensive emergency. This should lower health care costs for everyone. Over time, health insurance should cost your family less. That’s because more healthy people will pay more premiums to insurance companies, who will then make more money. They will be competing with each other on the exchanges, so will want to charge less to get more business. older people on Medicare will have more of their drug costs covered, meaning they can afford to take all their medicine as they should, and stay out of the hospital.
Common questions about the obamacare health plan
When is the deadline to sign up? The open enrollment period ends on Feb 15th 2015 to sign up. So, consumers have until then to sign up for coverage this year. Those who do not have health insurance before then–whether it was purchased on the marketplace or through their employer– will be required to pay a penalty. The next open enrollment period opens November 15, 2014.
Consumers must sign up by February 15 to have coverage take effect on March 1. You can still enroll after that deadline; you just won’t have health coverage until April 1. Originally, those without active coverage on March 31 would pay a penalty, but now, as long as you’ve signed up and paid for your plan before then, you will avoid the tax penalty. Please check your local office as effective dates can always change.
How much is the penalty for not having obamacare? Under the ACA’s individual mandate, the penalty in 2014 for not having health insurance is $95 per adult and $47.50 per child. The alternative is 1 percent of your total household income, whichever is greater up to a maximum equal to the national average annual premium for a “bronze” health insurance plan. The CBO estimates this to be approximately $5,000 for an individual in 2016 and $12,000 for a family. If you fail to obtain coverage, the fee will be applied to your annual taxable income for each month you don’t have health insurance beginning after March 31. In 2015, the penalty increases to 2 percent of your income. In 2016, it’s 2.5 percent of your income; by 2017, it will increase by the rate of inflation.
Can I qualify for an exemption so I don’t have to pay for insurance. The ACA’s so-called “hardship exemption” that exempts people from the penalty. (This is made on a case-by-case basis and ruled through the marketplace.) Some examples are below
You’re uninsured for less than 3 months of the year
The lowest-priced coverage available to you would cost more than 8% of your household income
You don’t have to file a tax return because your income is too low (Learn about the filing limit (PDF)
You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
You’re a member of a recognized health care sharing ministry
You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
You’re incarcerated (either detained or jailed), and not being held pending disposition of charges
You’re not lawfully present in the U.S.
You qualify for a hardship exemption
What kinds of health plans are offered under the obamacare health plans ? There are four types of plans available. They are referred to as the metallic plans. The bronze plan pays 60 percent of medical costs and has the lowest premiums; the silver plan—the standard plan– pays 70 percent of costs; the gold plan pays 80 percent; and the most robust plan, the platinum, pays 90 percent of costs and has the highest premiums. In all cases, the lower the premium, the higher the deductible. There’s also the catastrophic plan offered only to those 30 and under or those with the hardship exemption. These plans contain very bare bones coverage and have very narrow provider networks.