Obamacare News Blog

Affordable Care Act Overview

Everything you’ve ever wanted to know about ObamaCare (and a few things maybe you never wanted to know).

ObamaCare has Several Names

ObamaCare is the nickname for the Patient Protection and Affordable Care Act, however it is rare that you will find in print the Patient Protection. The exchange is known as the Health Insurance Exchange (HIX), Health Insurance Marketplace, and Exchange plans.

New Metal Plan Names

The new Exchange plans are known as “metal” plans. These plans are called the Bronze Plan, Silver Plan, Gold Plan, and Platinum Plan. These plans range from the percentage covered by the insurance company. Bronze should have the lowest monthly premium with the least financial coverage, whereas Platinum has the highest monthly premium with the least out-of-pocket costs.

Metal Plans are Sold Through Private Providers

There is a lot of confusion that these are government plans, but they are not. For example plans are sold through Anthem Blue Cross, Blue Shield of California, Kaiser, Health Net, among other providers.

On/Off Exchange Plans

There are both on and off Exchange planes. It is unclear whether off exchange plans will be metal plans sold out of the exchange or if they are separate plans that meet the ObamaCare essential health benefits.

Does Every Provider Have to Offer all 4 Plans?

No. However, if a provider does offer the new plans, that provider must offer a Silver and a Gold plan.

Enrollment Begins in October

The state and federal exchanges open on October 1, 2013, however the plans do not begin until January 2014

How Much Does Each Plan Cost?

That really depends on where you live, which plan you choose, and how old you are.  two differnt providers could offer the same metal plan at different prices.

There are Subsidies to Help Cover Costs

Both types of subsidies are based off income.

• Federal Premium Subsidies: To help with the monthly cost
• Federal Cost-sharing Subsidies: To help with copayments, deductibles, and coinsurance. This subsidy is only available on the Silver Plan

Seniors over 65 Do Not Purchase Metal Plans

Seniors do not do anything with the Affordable Care Act, as seniors will continue to receive Medicare, and are not allowed to purchase these plans.

Employees Cannot Purchase Individual Plans

Let me be clear about this: full-time employees (average of 30 hours or more per week) who are eligible for job-based insurance may not purchase an individual plan. Part-time employees may purchase plans through the Health Insurance Marketplace. As well as, we believe, employees who work for a small business with less than 50 employees will be able to purchase the new plans, as these companies are not mandated to offer insurance (except in D.C. and Vermont).

Employer Mandate Not Until 2015

What this means is that employers with 50 or more employees are not mandated to offer insurance or face a fine (called a tax by SCOTUS). So, this will change things for individuals because as of January 2014, individuals are mandated to enroll in their own insurance between now and then if their employer does not offer it.

Individual Mandate is Still On

Even though Congress is trying to stop the mandate, as of now individuals are still required to enroll in a health plan beginning January 1, 2014.

Guaranteed Issuance and Renewal

Pre-existing condition restrictions are as of January 2014 a thing of the past. This is called guaranteed issuance for ObamaCare. Plans also must guarantee your renewal regardless of illness according to the ACA.

Penalties for the Uninsured

There are two types of penalties one for individuals who choose not to enroll in a qualifying plan and one for business owners who are mandated to pay. In 2014, the ObamaCare penalty for an individual without insurance is $95 or 1% of your income. This goes up over the next few years. There are exemptions such as financial hardship or against your religious beliefs, contact the number above to see if you are exempt.

For further questions please call 800-930-7956 or contact Medicoverage.com.