What is Health Care Reform all about
Health Care Reform
The Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA), was signed into law in March of 2010.
How will health care reform affect you?
- Health care is available for individuals with pre-existing conditions. Starting in 2014, cancellations and non-renewals based on chronic illness are illegal. This includes both adults and children.
- Preventative services, such as diabetes and blood pressure screenings, are available at no cost as long as you utilize a network provider or PCP.
- Children can remain on their parents’ plan until age 26 (in some states up to age 30).
- Small businesses will receive a tax credit to offset the burden of offering health care in comparison to larger companies that can afford employee benefits.
- An 80/20 rule forces insurance providers to spend at least 80 percent of premium dollars on medical treatment, rather than advertising and executive bonuses. If they do not meet this requirement, they must offer a rebate to customers.
- Lifetime and annual dollar limits on essential medical treatments have been phased out, which means you will no longer be denied coverage once your medical expenses reach a certain dollar amount on a ACA plan.
Under the new Affordability Care Act, as mentioned, you are now eligible for some important preventative services, which can help you avoid illness and improve your health. The wellness program does not require a co-pay and is not subject to having the deductible being met. It covers your physical, screenings for cholesterol and diabetes, psa testing, pap smears, and mammograms, even a routine colonoscopy, (remember...you must utilize an in-network provider) see the following links for Adult, Women & Child Preventative Care Benefits.
This year the ACA open enrollment period (OEP) is from November 1st thru January 31st with the earliest effective date of January 1st, 2019. Unless you qualify for a Special Enrollment Period (SEP) or life changing event, that was the only time you can enroll or change plans.
Healthcare reform plans are not cut & dry and also it appears rules change on a daily basis. The networks on and off the exchange are not as broad as we have previously had. The majority of the plans are HMO networks (you must utilize in network providers otherwise there is No coverage and you would be responsible for all costs). Even the PPO networks (coverage is available out of network , but at higher out of pocket costs.) are not as large.
Remember those people employed by the Marketplace/Exchange are not Insurance Agents and are not fully knowledgeable about plans or networks and by the Law cannot advise. Coverage and premiums are the same whether you utilize the Marketplace/Exchange or a knowledgeable Insurance Agent. Who would you rather have assist you in making your decision?
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Our agency can help you select a health care policy to both cover your healthcare needs and your financial needs. Times of drastic change can be confusing. We are here to answer your questions and guide you to a viable solution. Contact us to today...We are only an email or phone call away!