Blue Cross and Blue Shield of Kansas
Health Care Reform and You
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What is the health care reform law?

The Affordable Care Act might have you asking lots of questions. Blue Cross and Blue Shield of Kansas is committed to helping you understand what’s changing and what it all means for you.

In 2010, the Patient Protection and Affordable Care Act became law. The law makes health insurance available to more people, and, depending on your situation, provides a tax credit to help pay for your health plan. You can also choose which plan you want to buy.

The law also creates a marketplace, or exchange, that offers different plans of varying cost. The plans fall into four metal coverage levels: bronze, silver, gold and platinum. These plans all offer the same essential health benefits with different out-of-pocket costs for things like doctor visits and hospital stays. The monthly cost, or premium, for these plans also varies depending on a number of factors, including the plan’s deductible and coinsurance amounts.

What is the timeline for health care reform?

Most of the law is now in effect. Young adults can stay on a parent's health plan until the age of 26 and there are no more lifetime maximums on benefit plans. The law also requires insurance companies to spend a certain percentage of premiums on claims and programs to improve quality, or refund premium dollars to their customers.

The Health Insurance Marketplace opened in October of 2013 and completed its first open enrollment period March 31, 2014. During an open enrollment period, Kansans can compare and purchase health plans and find out if they qualify for an advance premium tax credit to help pay for their plan. It is important to note that the Affordable Care Act mandates that most Kansans have health insurance in 2014. There are some exemptions, but the majority of people face a tax penalty if they do not have health insurance.

What is health insurance?

Health insurance can be a confusing concept, especially if you’ve never had a health plan. So, what exactly is health insurance? It’s an agreement between you (or your employer) and your insurance company to protect you from paying the full cost for medical care when you get sick or have to make a trip to the hospital if you’re injured.

Your health plan can cover doctor visits, prescription drugs, tests and other health care services. You pay a monthly fee, called a premium, for this coverage. You also may pay part of the cost when you need medical care and the insurance company pays part. These costs usually come in the form of:

  • Deductibles – for most services, the set amount you have to pay before insurance pays its part.
  • Copay – a fixed amount you pay directly to the doctor, hospital or other provider each time you receive certain services.
  • Coinsurance – the part or percentage of medical costs you pay once you meet your deductible; your health plan pays the rest.
How does health insurance work?
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What if I already have insurance?

If you buy insurance on your own there may be no need to change, depending on how long you've had your current plan. You do, however, have new plans to choose from, and you may be able to get an advanced premium tax credit to help reduce the cost of your insurance.

The same is true if you have insurance through your employer. Most companies will continue to offer health insurance to their employees.