Regardless of your politcal position on the Patient Protection and Affordable Care Act (PPACA), it is important to be prepared. The way you will be affected by the law will depend greatly on whether or not you currently have insurance and the type of coverage you have.
Catch up with the “YouToons” as they help make more sense of the basics of the law.
If you are self-insured or have no insurance, or you do not meet Medicaid or Medicare requirements and you are not covered by a plan from your employer, you are required to buy health insurance or be subject to a penalty. As of October 1st, 2013, exchanges otherwise known as Marketplaces where you can purchase insurance, have been set up by many states. If a state made the decision not to set up an exchange, the federal government will. Visit http://www.healthcare.gov to find the exchange in your state. Some of you have already experienced delays in getting through to the website because it is new and demand is high. Just be patient with the delays and try back periodically as things improve during the roll out phase. They have open phone lines with people to help you.
The Marketplace open enrollment window started on October 1st, 2013 and ends on March 31, 2014. The PPACA, requires individuals to have insurance coverage by January 1, 2014. The important thing to understand here is that people going on the exchange must choose and sign up for a plan by December 15th in order to have coverage in place before the deadline.
◦ Depending on your income, the Federal Government may help with the cost of your coverage through tax subsidies.
◦ The plans from which will choose have been given metallic names; bronze, silver, gold and platinum. Bronze plans are the lowest in cost, but they have potentially higher out-of-pocket expenses should you get sick or hurt and incur high medical expenses. The silver and Gold plans fall in between the Platinum plans. The Platinum plans come with much higher monthly premiums but offer far lower co-pay and deductible amounts.
◦ Be sure to review the plans carefully so you are able to decide which plan best suits your needs. WARNING: Be sure to review the networks available in each plan before you buy a policy because some plans may have very limited choices of doctors and hospitals.
◦ Should you decide to not buy coverage, you may incur a tax penalty. The penalty for 2014 is $95 per person or 1% of your income, whichever is greater. Most of us are not hearing about the 1% element, so think hard before you decide not to buy coverage it can be more than $95. The tax penalty will increase each year and will reach $695 per person or 2.5% of income by 2016.
What about Medicare and Medicaid?
I’ll mention just a few things about those programs that people should know.
•Medicare – If you have it you can keep it. There are changes and new benefits designed to improve benefits and reduce waste. Also, the Medicare Trust fund is extended until 2029.
◦ There will be no cuts to payments to doctors, hospitals or rehabilitation facilities.
◦ The doughnut hole in the prescription drug plan will close a little each year until 2020, at which point it goes away. Those who already have Medicare Part D will continue to pay for for out-of-pocket co-payments and premiums.
◦ There will be some preventative screening tests and wellness checkups added for no additional cost.
•Medicaid – Designed to provide health coverage to individuals who cannot afford to pay for it.
◦ The biggest change here is that there will be new eligibility standards intented to help those who cannot afford to pay for health insurance obtain Medicaid coverage. In the past adults who had no dependant children could not obtain Medicaid. This will change under the PPACA.
◦ In 2013, The ACA expanded Medicaid in some states to offer coverage to those under age 65 whose income is at or under $15,282 for an individual and $29,726 for a family of four in 2013 which represents 133 percent of the federal poverty level. So far only 24 states and the District of Columbia have agreed to the expansion. Click here to learn where your state stands on Medicaid expansion.
As you move ahead in this maze of choices, please know that we have resources availble to help you along the way. Please feel free to click on the Contact Link. Happy shopping!!!
