Wednesday, September 25, 2013

Get Ready for Obamacare!

Although many provisions of the Affordable Care Act have been implemented since it became law in 2010, the full implementation of  "Obamacare" will take place January 1, 2014.  There is a one year delay on the requirement that  large employers  (companies with over 50 employees) provide health care  insurance for their employees, but the most significant change is that each U.S. citizen must be covered by insurance with minimum essential coverage or face a fee . This fee is paid on the 2014 federal tax form, plus the uninsured person is liable 100% for any medical care they receive while they remain uninsured.

Most people will get health care insurance from their employer or government programs like Medicaid, Medicare, TriCare, etc. It's estimated that about 10% of the U.S. population doesn't have a government or employer sponsored insurance plan and must buy their own insurance. These people may utilize the Health Insurance Marketplace of their state beginning next week (October 1, 2013). Most people are eligible to use the Health Insurance Marketplace but are not required to use the Marketplace to obtain insurance. However, if they do not get their insurance through their state exchange, they will not be eligible for possible reduced rates based on their income level (400% or less of the federal poverty income guidelines). The exchange can be utilized on-line, by mail or in-person utilizing a broker or Navigator (person trained to assist you on the State Health Insurance Marketplace).

The Health Insurance Marketplace for your state will have been set up by your state or may be set up by the federal government where state legislators and governors have refused to implement the Affordable Care Act Health Insurance Marketplace initiatives. There will be four price levels of  insurance called Bronze, Silver, Gold, and Platinum with Bronze covering 60% of costs, Silver covering 70% of costs, Gold covering 80% of costs, and Platinum covering 90% of costs. The Benchmark level is the Silver Plan and this is the only plan which may provide advance premium tax credits to lower your monthly premium based on your family income level. If you qualify for the advance premium tax credits based on your family income, the cost saving for out-of-pocket costs will make it the equivalent of a Gold or Platinum Plan that cost more but have fewer out-of-pocket costs.

There is also a provision in the Affordable Care Act for citizens under the age of 30 to obtain very inexpensive Catastrophic Medical InsurancePeople 30 and over with low incomes for whom other insurance is not considered affordable or who have received a hardship exemption from the fee may be able to buy these catastrophic plans in the Marketplace.

I'm one of those people who doesn't have employer-provided insurance and since I am only 62 years old, I am not eligible for Medicare for another 3 years.  Since losing my employer-based insurance in 2006, I've had to buy insurance on my own.  I was denied insurance three times because of  "pre-existing  conditions" and had to obtain insurance from a state-based insurance plan for people like me.  I will be going on the New Mexico Health Insurance Exchange October 1st to see what other options I will have starting January 1, 2014.  On that date, insurance companies can no longer require that I pay a higher premium because of pre-existing conditions or because I am a woman. 

You can use the Health Care Cost Estimator now to get an idea of what the Benchmark insurance plan will cost you in your state based on your family size, 2014 income, number of dependents and age.

There's been a lot of over-the-top rhetoric and lies about Obamacare, so I suggest you look at the Healthcare website that explains all the benefits and changes in plain language.  

1 comment:

  1. Thanks for the clear explanation, Vicki. Though on Medicare I appreciate learning the details to understand what the furor is all about. It's all a step in the right direction but...... methinks something like the Canadian system will be better in the long run....:)