Thursday, July 25, 2013
Patriots Love The Benefits Of ObamaCare and Health Care Reform
Patriots Love The Benefits Of ObamaCare and Health Care Reform
Benefits of ObamacareAdvantages Offered By ObamaCare
As one benefit of ObamaCare, if you make less than 400% of the federal poverty level ($93,700 as a family or $46,021 as an individual), you may be eligible to receive subsidies and tax credits toward insurance purchased on your State's Health Insurance Exchange (Online Marketplaces where Americans can purchase insurance starting on October 1st, 2013). Cost assistance will help may low and middle income individuals and families to purchase affordable health insurance. Find out more about Receiving Subsidies, Tax Credits and Cost Assistance on the ObamaCare Health Insurance Exchange.
Because of the new health law, 12.8 million individuals and businesses got back more than $1.1 billion in rebates in 2012 from insurance companies who underspent on medical care.
Benefits of ObamaCare: A Quick Summary of ObamaCare Protections
ObamaCare offers you and your family many protections these protections include.
• No annual limits on healthcare
• Insurance companies can't drop you when your sick
• You can't be denied coverage for pre-existing conditions
• Obamacare has a strong focus on preventive services
• A large improvement to women's health services
• Reforms to the healthcare industry to cut wasteful spending
• Better care and protections for seniors
For a complete list of preventative services covered under the Affordable Care Act (ObamaCare) click this link.
A Quick Summary of ObamaCare "Essential Health Benefits"
The new ObamaCare health care law states that health plans offered in the individual and small group markets, both inside and outside of the Affordable Insurance Exchanges (Exchanges), offer "essential health benefits". Please note that grandfathered plans may not be required to provide these services. Read more information about ObamaCare "grandfathered plans".
Starting January 1st of 2014, the following "benefits" must be included under all insurance plans:
• Emergency services
• Laboratory services
• Maternity care
• Mental health and substance abuse treatment
• Outpatient, or ambulatory care
• Pediatric care
• Prescription drugs
• Preventive care
• Rehabilitative and habilitative (helping maintain daily functioning) services
• Vision and dental care for children
The following is a full list of protections and benefits available under ObamaCare from Consumer Reports:
Full list of Protections and Benefits Offered By ObamaCare (The Affordable Care Act) - 2010 - 2013
Whether your health insurance is purchased by you or your employer, the health law has outlawed practices that have left people without health insurance when they need it most. These protections include:
Curbs on canceling policies. Insurers can no longer cancel your policy if you get sick, a practice known as "rescission." They cannot cancel your coverage if you make an honest mistake on your application.
Rapid appeals. Consumers can appeal insurance company decisions to an independent reviewer and receive a response in 72 hours for urgent medical situations.
Ban on lifetime limits. Major or long-term illness can rack up serious medical bills. Health insurance policies used to set lifetime limits on how much they would pay for an individual's medical bills. These are now illegal, meaning people with insurance won't have to get into debt because their coverage runs out.
Annual dollar limits on their way out. Insurance companies can still set limits on how much they pay for an individual's medical expenses each year, but as of September 23, 2012, the law says this limit must be no less than $2 million. In January 2014, limits will be completely eliminated. Exceptions: Insurers can still impose other types of benefit limits like doctor visit limits, prescription limits, or limits on days in the hospital.
Free preventive care and annual checkups. The law focuses on prevention and primary care to help people stay healthy and to manage chronic medical conditions before they become more complex and costly to treat. New private health plans must cover and eliminate cost-sharing (co-payment, co-insurance, or deductible) for proven preventive measures such as immunizations and cancer screenings. Additional preventive measures for women kicked in August 2012, including free well-woman visits, screening for gestational diabetes, domestic violence screening, breast-feeding supplies, and contraception, all with no cost-sharing. Exceptions: Workplaces run by religious organizations that object to birth control do not have to pay for contraception, but insurers must pick up the cost. Existing plans that haven't changed significantly since passage of the law can continue to charge for preventive care until 2014.
Premium rebates if insurers underspend on care. The health law says that most insurers must spend at least 80 percent (85 percent for insurers covering large employers) of the premiums you pay on medical care and quality improvements. If insurers spend too much on overhead, such as salaries, bonuses, or administrative costs, as opposed to health care, they must issue premium rebates to consumers each summer.
Standard disclosure forms. Starting September 23, 2012, all health plans must use a standardized form to summarize benefits and coverage, including information on co-payments, deductibles, and out-of-pocket limits. Insurers must note any excluded services all in one place. Insurers must also calculate and disclose your typical out-of-pocket costs for two medical scenarios: having a baby and treating type 2 diabetes. Future years will include more coverage examples.
The law makes it easier for some uninsured Americans to find more affordable health insurance right now:
Young adults can stay on a parent's plan until age 26. Health plans must let young adults remain as dependents on their parent's policy until they turn 26, regardless of whether they live at home, attend school, or are married. Exception: Some health plans are not required to extend benefits to young adults if they can get coverage at work; this exception goes away in January 2014.
Chipping away at pre-existing condition exclusions. In 2014 insurers will no longer be able to deny coverage to people with pre-existing conditions or charge them more for premiums. Meanwhile, the health law offers some temporary help.
Adults with pre-existing conditions who have been without coverage for at least six months may be eligible for subsidized coverage through the temporary Pre-Existing Condition Insurance Plan in their state.
Children under 19 with pre-existing conditions cannot now be denied coverage by most insurers. Until 2014, however, insurers can charge more for premiums than they charge for someone without such conditions. Exception: Some individual plans can still refuse to cover a child. This exception goes away in January, 2014.
There is a 365 day waiting period for individuals with pre-existing conditions the BCBS terms and the ACA section "SEC. 101. NATIONAL HIGH-RISK POOL PROGRAM" we can verify that there is a 365 day waiting period for coverage of pre-existing conditions upon purchasing insurance (eliminated along with the pool in 2017).
There is also an "Exclusion Rider" policy that essentially says until 2014 you can be denied coverage on a medically underwritten health insurance policy. EX. You have had surgery previously and you need another operation for the same issue. There are other jargon-y worded restrictions (we'll need to study and report).
The PCIP Pre-exisiting Condition Insurance Plan: makes health coverage available to you if you are a U.S. citizen or reside here legally, you have been denied health insurance because of a pre-existing condition, and you’ve been uninsured for at least six months.
These plans are expensive and thus will most likely not cover low-income individuals. The Program ends in 2014 when insurance through the exchange will cover pre-existing conditions