GET THE POINT! Get started with five points on Healthcare Reform
Point# 1: Should you change your current insurance plan?
When the Affordable Care Act (ACA) was signed into law, it effectively created three classes of health insurance plans: grandfathered plans, transitional plans, and reformed plans.
People with grandfathered plans did not have to change their coverage in 2014, nor did some people with transitional plans. Your current insurance carrier can tell you what type of plan you are on presently.
Even though you may not need to change, a reformed plan may be a better option for some people. Consumers who understand what a reformed plan covers can make better decisions about their health insurance.
Point# 2: Do I have to be enrolled in an insurance plan? Is there a penalty?
The ACA tries to reduce the amount of uncompensated care the average U.S. family pays for by requiring everyone to have health insurance or pay a tax penalty.
The ACA’s new tax penalties for people without insurance are designed, in part, to offset the cost of paying for the health care of people without health insurance.
Important point: If you earn a lower income, you may be able to qualify for subsidies that make insurance more affordable. If you understand how the subsidies and tax penalties work, you’ll be in a better position to purchase the product that suits you best.
Point# 3: Understand a “Qualified Health Plan” sold on or off the Exchange
Since 2014, new health plans are structured differently. You need to understand those changes to help find the right plan for you.
Each plan must cover 10 essential health benefits (EHBs) and must have a metallic benefit level (bronze, silver, gold, or platinum). These plans must start at a minimum of 60% of the actuarial value (or average annual costs) per person. People under the age of 30 will also have the option of selecting Catastrophic plans with fewer benefits and lower costs.
The law also limited out-of-pocket costs, deductibles, and other forms of cost-sharing, based in part on your household
income.
Point# 4: In addition to Qualified Health Plans (QHPs), there may be other options
The ACA doesn’t create a one-size-fits-all health insurance market. Many carriers offer a broad range of “QHPs” and other types of health insurance products. Sorting through all these options can be an overwhelming task. Click here to get started and see what options are available for you!
Plans sold off government exchanges also have varying deductibles and metallic benefit levels, tiered provider networks, and varying benefits not covered by major medical health insurance plans, like vision, dental, accident, short-term, and critical illness insurance.
The price of insurance may vary based on the level of insurance you want when choosing a doctor netwrok or drug coverage.
Point# 5: The difference between a “qualifying event” and “open enrollment”
The open enrollment period, which allows you to shop for new health insurance plans each year, begins in November and runs through the end of January each year.
If you don’t buy health insurance during this open enrollment, it may be difficult to buy health insurance unless you have a “qualifying event”. Qualifying events include moving to a new coverage area or state, the loss of a job, marriage, divorce, the birth of a child, or loss of existing coverage.
Without health insurance you could face tax penalties and unfunded medical bills if you get sick or injured.
When the Affordable Care Act (ACA) was signed into law, it effectively created three classes of health insurance plans: grandfathered plans, transitional plans, and reformed plans.
People with grandfathered plans did not have to change their coverage in 2014, nor did some people with transitional plans. Your current insurance carrier can tell you what type of plan you are on presently.
Even though you may not need to change, a reformed plan may be a better option for some people. Consumers who understand what a reformed plan covers can make better decisions about their health insurance.
Point# 2: Do I have to be enrolled in an insurance plan? Is there a penalty?
The ACA tries to reduce the amount of uncompensated care the average U.S. family pays for by requiring everyone to have health insurance or pay a tax penalty.
The ACA’s new tax penalties for people without insurance are designed, in part, to offset the cost of paying for the health care of people without health insurance.
Important point: If you earn a lower income, you may be able to qualify for subsidies that make insurance more affordable. If you understand how the subsidies and tax penalties work, you’ll be in a better position to purchase the product that suits you best.
Point# 3: Understand a “Qualified Health Plan” sold on or off the Exchange
Since 2014, new health plans are structured differently. You need to understand those changes to help find the right plan for you.
Each plan must cover 10 essential health benefits (EHBs) and must have a metallic benefit level (bronze, silver, gold, or platinum). These plans must start at a minimum of 60% of the actuarial value (or average annual costs) per person. People under the age of 30 will also have the option of selecting Catastrophic plans with fewer benefits and lower costs.
The law also limited out-of-pocket costs, deductibles, and other forms of cost-sharing, based in part on your household
income.
Point# 4: In addition to Qualified Health Plans (QHPs), there may be other options
The ACA doesn’t create a one-size-fits-all health insurance market. Many carriers offer a broad range of “QHPs” and other types of health insurance products. Sorting through all these options can be an overwhelming task. Click here to get started and see what options are available for you!
Plans sold off government exchanges also have varying deductibles and metallic benefit levels, tiered provider networks, and varying benefits not covered by major medical health insurance plans, like vision, dental, accident, short-term, and critical illness insurance.
The price of insurance may vary based on the level of insurance you want when choosing a doctor netwrok or drug coverage.
Point# 5: The difference between a “qualifying event” and “open enrollment”
The open enrollment period, which allows you to shop for new health insurance plans each year, begins in November and runs through the end of January each year.
If you don’t buy health insurance during this open enrollment, it may be difficult to buy health insurance unless you have a “qualifying event”. Qualifying events include moving to a new coverage area or state, the loss of a job, marriage, divorce, the birth of a child, or loss of existing coverage.
Without health insurance you could face tax penalties and unfunded medical bills if you get sick or injured.
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