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Health Care Reform:

Health Insurance & Affordable Care Act

Have Insurance? How the Mandate Affects You

Wondering what health care reform means when you already have insurance through an employer or insurance you've bought yourself?

You don't have to make any changes and can keep your current coverage if you have insurance:

  • Through your job
  • As a dependent through a family member’s job (this includes children and spouses)
  • Through other types of health plans, such as Medicare, Medicaid, CHIP or a Veteran's health plan

If you buy insurance on your own without help from work, you may be required to switch from an older health plan that does not meet the law's minimum requirements to a new plan that does.Even if your insurer keeps your plan, you have the option to shop for a plan from your state's Marketplace, also called an Exchange. When you enroll through a Marketplace, you might qualify for financial help, called a subsidy.

 

Spouse Covered By an Employer's Plan

By 2015, companies with more than 50 employees must offer you affordable, minimum health coverage. And they must cover your children ages 26 and younger. But they do not have to cover your spouse. Most employers that offer dependent coverage also cover spouses, but they are not required to do so.

If you’ve been using insurance from your spouse’s employer and the company stops covering spouses, first see if your own company offers a health plan. That's likely to be your most comprehensive and affordable option. If not, look for an individual plan in your state's Marketplace

 

If You're Over 30 & Have a Catastrophic Plan

Catastrophic plans cost less and have fewer benefits, and they typically work best for young, healthy people. If you're 30 or older, you can only enroll in a catastrophic plan if buying a more comprehensive plan would cost more than 8% of your income.

If that's not the case, you'll need to enroll in a new health plan. Your state's Marketplace offers plans at different levels, called tiers – bronze, silver, gold, and platinum. . You may want to consider a bronze-level plan, which has a less expensive monthly premium and is most similar to a catastrophic plan. A bronze plan, though, will cost you more each time you see a doctor or fill a prescription than a silver or gold plan would. What you pay for each time you get health care is called your out-of-pocket costs.

 

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