Have questions about the Affordable Care Act, widely known as Obamacare? You might just find your answers here.

1. Health Care Reform Answers
Lots of changes are happening in health care.
We’re here to help you understand what it means and what you may need to do.
What is the Affordable Care Act?
The health care reform law, or the Affordable Care Act (ACA), was passed by the federal
government on March 23, 2010. The law makes health insurance available to more people.
What does the new law do?
It makes insurance available to more people, so more people
can get the care they need. And that is good news!
n It expands the essential benefits and services covered by
health plans.
n It allows you to compare health plans more easily, since
all insurance companies must show the benefits and costs
of their health plans in the same format.
n You may be able to get help paying for a health plan.
What is the Marketplace?
The government set up an insurance exchange Marketplace where
people can shop and compare health plans online. We can walk
you through the Marketplace, help you buy a health plan that
meets your needs and then help enroll you in the plan. We’re with
you every step of the way. Call the phone number on this website
or click Chat Now for more details.
If you have any questions, we encourage you to call the phone
number listed on this website. Talk to us one-on-one for answers to
your specific health insurance questions. We can explain your
options and help you through the next steps to take.
The cost of a health plan depends on:
n The ages of everyone applying for coverage
n The size of your family
n Where you live
n Whether you use tobacco (if you do, you’ll pay more)
How can Florida Blue help me?
We’re here to help you understand how the law may
change things for you and your family.
If you have any questions, we encourage you to call the
phone number listed on this website or click Chat Now.
Talk to us one-on-one for answers to your specific health
insurance questions. We can explain your options and
help you through the next steps to take.
How will my health affect
getting health insurance
coverage?
Everyone can get a plan. Beginning in 2014, you can’t
be turned down or charged more for insurance even if
you have been sick or have a health condition. Instead,
everyone who applies for individual health insurance is
guaranteed coverage.
Once you’re enrolled in a plan, your coverage cannot
be cancelled if you have a health problem.
What do I need to do?
Starting January 1, 2014, most everyone in the United
States will need to buy a health plan or pay a fee. You
can enroll in one of the new health plans from
October 1, 2013 until March 31, 2014.
What are cost sharing reductions?
If you buy a health plan from the ”Silver” category through the Marketplace, and your
income is below a certain level, you may get a discount on your health care services. This
lowers the cost you’ll pay out of your pocket for your doctor or hospital visits, prescriptions, etc.
This information is for illustrative purposes only and is being provided to help increase understanding of the impacts of some of the provisions of the Affordable Care Act (ACA). It does
not attempt to cover all of the law’s provisions and is not intended as tax or legal advice. We encourage members to seek professional advice, including legal counsel, regarding how the
new requirements may affect you.
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
78141-0913

2. Health Care Reform Answers
Can I get help paying for my health
plan?
If you qualify, the government will help you pay a part of the
cost for your health plan through the Marketplace. These
lower costs are handled with a tax credit (or subsidy) called
the advance premium tax credit. We can help you connect to
the Marketplace to find out your actual tax credit amount. The
tax credit can be applied right away to your monthly health
plan premiums, so you get the lower costs immediately.
The tax credit amount depends on things like your household
income, your family size and ages, as well as where you live.
Example of how a tax credit works
with a health plan:
The monthly cost for a health plan
(cost depends on which health plan you
choose)
$334
per month
Subtract the government tax credit
(money paid to the insurance company)
– $183
per month
You would pay
$151
per month
Single person, age 49, living in Duval County with an annual
income of $25,000.
What is the age limit to be qualified as a dependent?
Your unmarried children or stepchildren (by birth, legal adoption, or legal guardianship) can stay
on your health insurance policy until they reach age 30, unless they are able to get insurance
through their job.
Extra help for children...
For kids under 19, all health plans on the Marketplace will include vision care and some will
include dental care. You can buy similar plans from Florida Blue.
What are my plan options through the
Marketplace?
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Are there other plans
I can choose from?
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The Marketplace offers four “Metal”
categories of health plans: Platinum,
Gold, Silver and Bronze. These metal
levels can help you compare plans. The
four categories cover the same set of
benefits, but vary based on the monthly
premium amount and how much you pay
out-of-pocket for health care services
for things like doctor or hospital visits.
Coverage is effective January 1, 2014.
People under 30 and some people with limited incomes may buy
what is called a “catastrophic“ health plan. It protects you from
very high medical costs.
Do the plans include maternity coverage?
What are the essential benefits
required by the law?
While Florida Blue covered most of these benefits
and services before the new law, all of the new health
plans for individuals and small businesses must include
a comprehensive list of items and services known as
‘Essential Health Benefits’. These include things like
emergency services, hospitalization, maternity and
newborn care, mental health and substance
dependency services, prescription drugs,
preventive and wellness
services, pediatric dental
and vision care. We can
explain your options and
help you through the next
steps to take.
Yes, as part of the Affordable Care Act, maternity
coverage is now included in all our new plans.
This information is for illustrative purposes only and is being provided to help increase understanding of the impacts of some of the provisions of the Affordable Care Act (ACA). It does
not attempt to cover all of the law’s provisions and is not intended as tax or legal advice. We encourage members to seek professional advice, including legal counsel, regarding how the
new requirements may affect you.
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
78141-0913

3. Health Care Reform Answers
If I purchase a health plan now – can I
switch to a different one if I don’t like it?
No. Special timelines now apply for enrollment. Each year there
will be an Open Enrollment Period when you select a plan.
However, there are also Special Enrollment Periods for special
circumstances, which include birth, marriage, loss of job, etc.
What are my options if I only need
health coverage while I’m between jobs?
You may qualify for coverage under a Special Enrollment Period.
Do you offer dental insurance?
If you had your Florida Blue health plan on March 23, 2010, you
may be able to keep it.
Some health plans purchased after March 23, 2010, have
undergone changes to be consistent with the health care
reform law, and may no longer be available to you on
January 1, 2014.
Call the phone number on this website or click Chat Now to
get all of your questions answered about your plan.
No. For new plans being sold starting October 1,
2013, you can’t be denied health coverage
because of your medical history. This means that
your medical history cannot be used to determine
the cost of the health insurance coverage you
choose. Exception: If you’ve been enrolled in the
same plan since March 23, 2010, you may be able
to keep it. To add anyone to this particular plan, a
medical exam or questionnaire may be required.
Generally, if you want to lower your monthly
payments, choose a plan with a higher deductible
and a higher coinsurance amount. The idea is that
the more you share the cost of your health care, the
less you will pay for the plan. We offer several plan
options to fit your monthly budget. And if you are
eligible for a tax credit, you may be able to get help
from the government to lower the monthly cost of
your health plan premium.
Yes, you can purchase dental coverage as part of your health
plan or as a separate policy.
Can I keep my current health plan?
Will I have to take a medical
exam to get coverage?
How can I save on my monthly
premiums?
How do I choose a plan?
It’s easy! You can use this website to find plans and
prices right away, plus check if you qualify for a tax credit
to lower your monthly premium. You can even create an
account to save your information and return later.
Feel free to call us at the phone number
listed on the website or click Chat Now,
so we can help you get the plan that
fits your needs and budget. We’ll help
you enroll in a plan that works for you –
whether on the Marketplace or not.
If I purchase a health plan, do I still need
Supplemental Insurance?
Supplemental insurance such as Accident, Critical Illness, and
Hospital Indemnity can help protect your savings, since they pay cash
directly to you to help pay for deductibles and copays, mortgage/rent,
childcare or other costs, while you recover.
While your health care plan is intended to provide coverage for most
major medical costs, if you’re out of work or on a fixed income, you
might not be able to cover unplanned or even everyday expenses.
How Florida Blue Can Help
At Florida Blue, we’re with you every step of the way. We’ll help you make sense of health insurance and get the care you need to be as
healthy as you can be. If you have any questions, we encourage you to call the phone number listed on this website, click Chat Now, or
you can visit a nearby Florida Blue Center (floridabluecenters.com).
This information is for illustrative purposes only and is being provided to help increase understanding of the impacts of some of the provisions of the Affordable Care Act (ACA). It does not attempt to cover all
of the law’s provisions and is not intended as tax or legal advice. We encourage members to seek professional advice, including legal counsel, regarding how the new requirements may affect you.
Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
78141-0913