Confused about health insurance under the new health reform law? You're not the only one! There's a lot of misinformation out there.
Here are some common myths -- along with correct information you can use to make informed decisions.
MYTH? Insurance policies are too confusing. There's no way an average person can understand them.
The health reform law calls for insurance companies to use plain language when they describe their policies.
As of Sept. 23, 2010, insurance companies have to use an easy-to-understand form that clearly describes benefits and coverage. It's called a summary of benefits and coverage. All insurance companies will use the same one. That will make it easier to compare plans.
MYTH? If you get confused about insurance options, there won't be any way to get help in figuring it out.
The new law gives money to each state to set up a consumer assistance program. The program can help you understand your options when you're looking for insurance. It can also help when you:
- Enroll in a health plan
- Need to file a complaint
- Appeal a company's action or decision
- Need to find out your rights and responsibilities
Not all states have a consumer assistance program. But more than half are in the process of setting one up. If your state doesn't have a consumer assistance program, there are other agencies that can help you.
MYTH? You're going to have to give up your current insurance and buy a policy online.
You don't have to give up your current health plan. For instance, if you have insurance through your employer you can still keep it.
If you don't have insurance through your job, there will be a place on the Internet to buy it. In the fall of 2013 health insurance Marketplaces (also called Exchanges) were set up in each state. You can enroll in an insurance plan through the Marketplace.
Even if you have insurance through your job you can still shop for coverage on the Marketplace if you want. But you don't have to. If you are happy with the plan your employer offers, you don't need to do anything.
MYTH? Insurance Marketplaces are cheaper because people can get a tax credit to help buy a plan.
That is true for certain people. The federal government offers tax credits to certain families that meet the financial requirements. The credit is to help them afford insurance.
MYTH? The government's going to tell your family what doctors you're allowed to see.
Not true. Under the law, even the insurance company is limited in terms of telling you what doctor to see or not see.
An insurer can't stop you from seeing any primary care doctor or pediatrician that's in the insurer's network. If you want you can see a doctor who's out of the network. However, if you want to see a doctor out of the network, you may have to pay more of your own money.
There are some instances where you will need a referral from your doctor to see another doctor. However, that is not true for certain specialists. For example, if you're a woman, you won't need a referral to see any gynecologist in the network.
Also, you and your family will be able to get emergency treatment at any hospital, whether it is in the plan's network or not.