Affordable Care Act / Obamacare / Covered CA - Get Subsidy Financial Assistance Coverage Today

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Affordable Care Act / Obamacare / Covered CA - Get Subsidy Financial Assistance Coverage Today

What Is the Affordable Care Act (ACA)? 



The Affordable Care Act (ACA) is the comprehensive healthcare reform signed into law by President Barack Obama in March 2010. Formally known as the Patient Protection and Affordable Care Act (PPACA), and often just called Obamacare, the law includes a list of healthcare policies intended to extend
health insurance coverage to millions of uninsured Americans. 

The Act expanded Medicaid eligibility, created health insurance exchanges, mandated that Americans purchase or otherwise obtain health insurance, and prohibited insurance companies from denying coverage (or charging more) due to pre-existing conditions. It also allows children to remain on their parents' insurance plan until age 26.

As part of the Act, subsidies for coverage purchased ave been increased, and eligibility for subsidies has been extended to higher income levels.  

All plans offered in the Marketplace must cover pre-existing conditions

Key Points  

·      The Affordable Care Act (ACA), also known as Obamacare, was signed into law in March 2010.

·      It was designed to extend health coverage to millions of uninsured Americans.

·      The Act expanded Medicaid eligibility, created a Health Insurance Marketplace, prevented insurance companies from denying coverage due to pre-existing conditions, and required plans to cover a list of essential health benefits.

·      Lower-income families qualify for subsidies for coverage purchased through the Marketplace.

Understanding the Affordable Care Act (ACA) 

The ACA was designed to reduce the cost of health insurance coverage for people who qualify. The law includes premium tax credits and cost-sharing reductions to help lower expenses for lower-income individuals and families.

 

Premium tax credits lower your health insurance bill each month. Cost-sharing reductions, meanwhile, reduce your out-of-pocket costs for deductibles, copays, and coinsurance, as well as lowering your out-of-pocket maximum: the total amount you pay in a year for covered health expenses.

 

All ACA-compliant health insurance plans—including every plan that's sold on the Health Insurance Marketplace—must cover specific "essential health benefits" including:

 

·      Ambulatory patient services

·      Breastfeeding

·      Emergency services

·      Family planning

·      Hospitalization

·      Laboratory services

·      Mental health and substance use disorder services

·      Pregnancy, maternity, and newborn care

·      Prescription medications

·      Preventive and wellness services and chronic disease management

·      Pediatric services

·      Rehabilitative and habilitative service

 

 

In addition, the ACA requires most insurance plans, including those sold on the Marketplace, to cover at no cost to policyholders a list of preventive services. These include checkups, patient counseling, immunizations, and numerous health screenings. It also allowed states that opted in to extend Medicaid coverage to a wider range of people.

 

Every year, there is an open enrollment period on the Health Insurance Marketplace during which people can buy or switch insurance plans. If you miss this time, you cannot enroll until the following year unless you qualify for a special enrollment period because your circumstances change--for example, you marry, divorce, become a parent or lose a job that provided health insurance coverage. 


Additional Required Benefits
Plans must also include the following benefits:

· Birth control coverage
· Breastfeeding coverage

Essential health benefits are minimum requirements for Federal / State Marketplace plans. Specific services covered in each benefit category can vary based on each state’s requirements. Plans may offer additional benefits, including:

· Dental coverage
· Vision coverage

· Medical management programs (for specific needs like weight management, back pain, and diabetes)

“ Metal Tier ” Plans

Plans are labeled ‘Metal tier’ plans – Bronze, Silver, Gold and Platinum.
Coverage benefit levels are offered as follows:

· Bronze = 60 percent coverage coverage with respect to essential benefits
· Silver = 70 percent coverage with respect to essential benefits
· Gold = 80 percent coverage with respect to essential benefits
· Platinum = 90 percent coverage with respect to essential benefits

As a Certifed Agent / Agency for Obamacare plans including Covered CA, we can assist you to compare out the specific plans for your situation, and find the best rates and assistance for you from the quotes generated. There is no additional cost for this service.
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