One of the key measures of the new health reform law is that it will ultimately extend coverage to millions of Americans without health insurance. Here's a rundown of the benefits that will become available to the uninsured and when each will be implemented.
Starting Jan. 1, 2014
- Insurance becomes a must. Central to the Patient Protection and Affordable Care Act is extending health insurance to millions of Americans who currently aren't covered. As a result, most people will be required to buy insurance or pay an annual fee - a maximum of $695 for individuals and $2,250 for families. Low income and religious beliefs may exempt you from this mandate.
- Health insurance exchanges. Health insurance exchanges will provide a marketplace where small businesses and people who don’t get health insurance through their employer can shop for plans. The exchanges will offer health care consumers the full range of both private and public health insurance options available to them in their state.
- Help paying for coverage. If you’re an individual making $43,000 or less, or a family of four making less than $88,000, the government will subsidize premiums - the monthly payment you make to insurers for coverage - for health plans purchased through health insurance exchanges so that coverage is more affordable. You’ll be required to pay anywhere from 2% to 9.5% of your income for health insurance, and the government will pick up the rest. Reduced copayments, coinsurance, and deductibles may also apply to assist with the cost of coverage. In addition, the new law states that the cost of premiums can be no more than three times as expensive for older people than for younger people.
- Offering choice/options. If your employer offers insurance, but you’ve gone without benefits because your share of the coverage is too expensive, relief is in sight. The government will allow you to apply the dollar contribution your employer would have made toward insurance to help pay for a more affordable plan in the newly established health insurance exchanges.
People With Health Conditions
Already in effect:
- Coverage for the medically uninsurable. In July, new high-risk pools offering health insurance to people with pre-existing medical conditions unable to gain coverage on their own in the private market (this is for people who do not get insurance from their employer) kicked into gear. In order to qualify, you must be without insurance for six months. You’ll also have to demonstrate that you’ve applied for, and been denied, insurance in the private market. To apply for coverage in your state’s high-risk plan, check with your state's department of insurance for an application.
Starting Jan. 1, 2014:
- Insurers can’t deny coverage based on health status. The days of insurers denying consumers the opportunity to buy health care coverage because of a pre-existing medical condition are numbered. Once implemented, insurers will have to sell an insurance policy to everyone, and, they’ll be banned from charging more for that policy based on health status or sex.