During the past week, many of my fellow American following me here have asked me about Obamacare (the Affordable Care Act), so I decided to do an info post with some of the general information about the upcoming changes to health care. The official government website for this legislation is a bit of a mess to navigation and, while I appreciate trying to give uninsured Americans all the information about this new law, it’s a little bit of data overload. For COMPLETE and SPECIFIC information about how this law will effect you, I suggest going to Healthcare.gov. This post is meant as introduction with general information which, frankly, the Obama administration has done a poor job of conveying to the American public … unless, of course, Obama’s Tumblr reblogs this.. then…forget I mentioned it.
Who does this law effect?
Americans who are currently uninsured or those who are currently buying their coverage directly from insurance providers.
What if I have health insurance through my job? How does it effect me?
First of all, lucky you for having a job that provides health insurance. You can pretty much stop reading this post and go reblog more cat gifs because this law will not change a damn thing in your life.
Okay, so I need some basic info on what kind of coverage I can get…
Health insurance providers will break down coverage into five categories: Catastrophic, Bronze, Silver, Gold and Platinum. The difference between the categories is mainly how much you will pay out of pocket for insurance with, the Platinum category having the most expensive monthly rate and Catastrophic category being the least expensive monthly rate. Most of these categories have subsidies to help pay for these monthly premiums if you qualify.
Great. Catastrophic is the cheapest … SIGN ME UP!
Hold on. The catastrophic plan comes with more restrictions than the other plans. First, you will only qualify for this plan if you are under 30 or if you have a limited income (if you make too much to qualify for medicare, but not enough to pay monthly premiums of other plans). Also, a catastrophic plan generally requires you to pay all of your medical costs up to a certain amount, usually several thousand dollars. However, 3 primary care visits per year and some limited preventive care is covered by the plan with no out of pocket cost to you.
So, I’ve decided on a plan, what exactly does it cover?
By law, all categories must cover the following essential health care: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
But…how do I pay for this? I need a little help. The premiums are still too high.
Well, if you are an individual making between $11,490 to $45,960 a year, then you will qualify for tax subsidies to help shoulder the monthly costs. Tax subsidies are also available for families. Visit Healthcare.gov for specific income ranges. It depends on how large your family is.
I think I make less than $11,000… what now?
You may qualify for your State’s medicare program which offer no cost or low cost coverage. Medicare is also expanding in certain States, so I’d advise you to check with your State’s medicare website.
Blerg, I don’t want to enroll in any healthcare plan. I know it’s mandatory but… come at me, government…
There is a penalty to those who do not enroll in any healthcare plan. The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher. And, of course, if you get into some car accident or become sick, you’ll have to pay for all of your healthcare yourself. Good luck with that.
How do I get the ball rolling on this?
Starting on October 1, 2013, health care exchanges will be open so you can sign up and see EXACTLY how much healthcare plans will cost and if you qualify for subsidies. Once you sign up for coverage, your insurance will kick in starting January 1, 2014. Open enrollment ends on March 31, 2014. If you haven’t signed up for coverage by this deadline, you won’t be able to get health coverage through the Marketplace until the next annual enrollment period, unless they have a qualifying life event. Also, if you haven’t signed up for health coverage by deadline, you’ll be subjected to the penalty (see above).
Great, I need more information, where can I find it?.
Many states have their own websites with specific information for their residents. General information can be found at Healthcare.gov. Here are States that have their own websites for the Affordable Care Act.
District of Columbia
If you do not see your State listed here, you can apply for coverage at the federal government’s official website over here.
Wow, this post is useful. Why are your other posts so useless…
Hey, now. I love Canadian cop dramas, okay! I just hope this helps some of you. This is my attempt at being Bill Clinton, honorary secretary of explaining stuff.