Obamacare, Marketplace, Glitches…What Does It All Mean?

Obamacare, marketplace, glitches…there are a lot of buzzwords in the media that are leading many Americans to ask “Does this affect me?” or “Am I going to lose my healthcare?”. To help Americans interpret this information, here is a simple breakdown of what is currently going on with the Affordable Care Act and how it may affect you.

The Affordable Care Act was signed on March 23, 2010 and instituted several reforms that improve access to affordable health coverage and limit abusive policies from health insurance carriers. Some of these changes have included: prohibiting denying coverage of children based on Pre-Existing Conditions; eliminating lifetime limits on essential benefits, like hospital stays; and increasing Medicaid payments for primary care doctors.

The Affordable Care Act has been a hot topic in the media lately because on October 1, 2013 the Marketplace for private insurance opened online at www.healthcare.gov. Essentially, the site serves as an online marketplace where Americans can shop for private insurance through “exchanges”. The site was set up because the Affordable Care Act mandates that as of January 1, 2014, all individuals not covered by an employer sponsored health plan, Medicaid, Medicare or other public insurance programs (such as Tricare), must purchase a private-insurance policy or pay a penalty. There are some exceptions such as financial hardship or if someone is a member of a recognized religious sect exempted by the Internal Revenue Service. The penalty is $95 per adult and $47.50 per child (up to $285 per family), or 1% of your income, whatever is higher.

On the site, www.healthcare.gov, consumers can browse a variety of health plans that meet certain benefits and cost standards. Americans who earn less than 133% of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will also be eligible to enroll in Medicaid. Open enrollment for these programs runs through March 31, 2014. December 14 is the cut-off date if you want your plan to start January 1. The government has set up 24-hour call centers to help people with open enrollment. Call 1-800-318-2596 (TTY: 1-855-889-4325).

The bottom line: If you currently have health insurance through your employer you do not have to do anything. However, if you’re uninsured you will want to purchase a health plan through the new exchanges to avoid paying a penalty in 2015.

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