The new health care reform law, the Affordable Care Act, probably has 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 will also be able to choose which plan you want to buy.
The new law also creates a marketplace, or exchange, that will offer different plans of varying cost. The plans fall into four metal coverage levels: bronze, silver, gold and platinum. These plans will 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 will vary depending on a number of factors, including the plan’s deductible and coinsurance amounts.
Many provisions of the law are already in effect, such as young adults being able to stay on a parent’s health plan until the age of 26 and no more lifetime maximums on benefit plans. Other parts of the law are now requiring insurance companies to spend a certain percentage of premiums on claims and programs to improve quality, or refund premium dollars to their customers.
The next big step for the Affordable Care Act is the Health Insurance Marketplace. Beginning Oct. 1, 2013, you will be able to go the online Marketplace and shop for a health plan. It’s a process called "open enrollment." You will be able to compare health plans and find out if you qualify for an advance premium tax credit to help pay for your plan. Coverage can begin as early as Jan.1, 2014. 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 will face a tax penalty if they do not have 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:
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 will, however, have new plans to choose from beginning Oct. 1, 2013, 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.
While most Kansas residents will be required to have health insurance under the Affordable Care Act, there are some who will be exempt from the individual mandate.
The law allows exemptions for members of Native American tribes and certain religious groups, undocumented immigrants and people who are currently incarcerated.
The law also allows for exemptions for people with incomes below the threshold of filing federal income tax and for those who would have to pay more than 8 percent of their income for health insurance.