The Affordable Care Act and Ways You Already Benefit

There is so much confusion being spread about what the Affordable Care Act does and does not do, that it can be hard to know whether it's worth it all or not. Here are some ways many people already benefit from this important law:

• Students up to age 26 can remain on their parents' health insurance plans. Many young adults just getting out of college struggle to find a full-time job which provides health benefits, so in one stroke the law increased the number of people with health insurance. This started with plans beginning on or after September 23, 2010.
• Uniform Coverage Summaries for Consumers requires all plans to provide a uniform summary of benefits and coverage, making it easier for individuals and businesses to compare plans and to understand what is and is not covered by the plans. Kind of like making sure that you are comparing apples to apples, and not apples to lemons. This went into effect in 2012.
• Children cannot be excluded from a parent's health coverage because of the health status of that child. This went into effect in 2010, and meant that thousands of children with chronic health conditions like juvenile diabetes would not be without health insurance.
• Starting in 2010, new health plans had to provide certain preventive services without "cost-sharing" for patients. These preventive services include recommended immunizations and screenings, as well as preventive check-ups for children.

More changes (and benefits) are coming in the very near future:

• Starting in 2014, adults cannot be denied health insurance because of pre-existing health conditions. Those with pre-existing conditions also cannot be charged more for health insurance than those who are healthy. So, say you have Type II diabetes and you decide to change jobs: if your new employer offers health insurance to the other employees, you cannot be denied the same health insurance coverage, nor can you be required to pay more for your insurance than your coworkers (if employees contribute to their health insurance coverage).
• Starting October 1, 2013, you can visit the Health Insurance Marketplace to find a health insurance plan that meets your needs. All plans in the marketplace will be required to meet minimum levels of coverage. Some states have created their own "exchanges", others use the federal "exchange". Visit www.healthcare.gov and click on the "See Your Options" button for more information, even before Oct. 1.
• Starting in 2014, even "grandfathered" plans must eliminate annual limits for coverage; lifetime limits were eliminated in 2010. Grandfathered plans are employer health insurance plans that were in place on March 23, 2010, and are restricted in what changes may be made to the plans.

For even more information about the Affordable Care Act and how it's changing health insurance for everyone, visit either HealthCare.gov's "How does the health care law protect me?", or the Kaiser Family Foundation Health Reform site.

Health Insurance Marketplace, and the Affordable Care Act

October 1 marks the beginning of open enrollment for those who do not have health insurance. Do you know what that means to you and your family? If you are not sure if you need to take part or not, start now by visiting HealthCare.gov.  You can find answers to many of your questions on the "Individuals" page at www.healthcare.gov/families/, such as what the Marketplace is, what the insurance covers, what your rights are, what to do if you are self-employed. If you already have health insurance, there are answers about what the Affordable Care Act already does for you.

Some facts that everyone needs to know:

• Pennsylvania residents will need to use HealthCare.gov to apply for coverage, compare available plans, and enroll. 
• Starting in 2014, health insurance plans can't refuse to cover you or charge you more just because you have a pre-existing health condition. (Unless you keep your previous individual insurance, which is considered "grandfathered" in and does not have to meet this requirement. See the site for more details.)
• Most health plans must cover a set of preventive services like shots and screening tests at no cost to you.
• If you run an income-generating business with no employees, then you're considered self-employed (not an employer) and can get coverage through the Marketplace.
• Some fraudsters may try to convince you to pay for help signing up.  The Marketplace has trained assisters in every state to help you at no cost. You should never be asked to pay for services or help. Double check any information that is confusing or sounds fishy. Call the Health Insurance Marketplace at 1-800-318-2596 if something doesn't sound right.

By learning more now, you can be ready when October 1 comes around!