The Patient Protection and Affordable Care Law of 2010, amended by the Health Care and Education Reconciliation Act of 2010, are referred to collectively as the “Affordable Care Act.” Today, we will refer to it as the “Health Care Law.”
The Health Insurance Marketplace is a new way to find and buy health insurance, apply for Medicaid and the Children’s Health Insurance Program (CHIP). The Marketplace is designed to help you find health coverage that fits your budget, with less hassle. Qualified individuals and employers can shop for affordable, private coverage from Qualified Health Plans.
Qualified Health Plan will cover a core set of benefits called Essential Health Benefits. New and expanded programs will be directly linked. You will have guaranteed coverage and renewability, regardless of a pre-existing condition (like cancer or diabetes), sex, age, etc. Qualified Health Plans in the new Marketplace will be sold and run by private companies and insurance agents.
AGE: BROKEN DOWN INTO 3 CATEGORIES *Except VT, NY
► 21 Years old: Rating factor=1.0 This means they are the reference point
► 49 years old: Rating factor =3.0 This means they will pay up to 1.7 times as much as a 21-year –old
► 65+ years old: Rating factor =3.0 This means they will pay up to 3 times as much as a 21-year-old+
► Determines which insurance system you will go through. Same choices, just different systems.
► Federally Facilitated Marketplaces
► State Based Marketplaces and
► Partnership Marketplaces
Don’t get caught with your pants down, it’s not worth it. Having no medical coverage can cost more than a penalty, it could cost a life. The purpose of the new law is to protect everyone in the country from astronomical medical bills, should the need arise. It is also an attempt to stop insurance companies from escalating premiums in the future.
Even within the same state, there can be small differences between health insurance plans. When you fill out your application and compare plans, you’ll see the specific health care benefits of each plan.
No matter which metal category you choose, you can save a lot of money on your monthly premium based on your income.
When you fill out a Marketplace insurance application, you’ll find out if you qualify for these savings. Learn how you can save on your monthly insurance bill with a premium tax credit..
PPO or “Preferred Provider Organization” plans are the most popular with Individuals and Families.
If you already have an insurance plan and want to keep it, review your benefits to see which services are covered.