Basic information to help understand requirements for 2013 Affordable Healthcare initiative.

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AFFORDABLE HEALTHCARE ACT 2013
Presented by: Jennoa R. Graham, Ph.D.
Friday, October 11, 2013

2.  Affordable Healthcare Website
 Highlight website areas for review
 Key Features
 Benefit Specific
 Yearly Breakdown
 Penalties
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http://www.hhs.gov/healthcare

3.  Selection Tips
 Application
 Additional Resources
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http://www.hhs.gov/healthcare

4.  http://www.hhs.gov/healthcare
 Links to follow
 About the Law
 Prevention and Wellness
 Facts and Features
 Read everything
 Set aside at least 2 hours
 If the lettering is blue, click it for more information
 If you get lost.. Click “Home” under Insurance
Marketplace
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http://www.hhs.gov/healthcare

5.  On March 23, 2010, President Obama signed the
Affordable Care Act. The law puts in place
comprehensive health insurance reforms that will roll
out over four years and beyond.
 Designed for %15 of Americans who do not have
health insurance. Rates/subsidy income based.
 NOT for Americans that have insurance through their
place of employment or Medicare.
 Law prohibits lifetime or annual limits for benefits;
review 2014 plans carefully for any terms like
“exclusions or “grandfathered” in the text.
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http://www.hhs.gov/healthcare

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http://www.hhs.gov/healthcare

7.  Benefits for Adults
 Insurance options
 Preventative Service Coverage
 Lower Costs
 No Cost screenings
 Pregnancy benefits
 Children Coverage
 Coverage up to age 26
 Preventative Service Coverage
 Vaccinations
 Emotional & Behavior wellness
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http://www.hhs.gov/healthcare

8.  Services for Seniors
 Medicare Preventative Services
 Medicare Drug Discounts
 $250 Rebate for Prescription Drugs
 Strengthening Medicare
 Holding Insurance Companies Accountable
 Justify rate increases greater than 10%
 Can not refuse coverage for pre-existing conditions
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http://www.hhs.gov/healthcare

9.  2010: A new Patient's Bill of Rights goes into
effect, protecting consumers from the worst
abuses of the insurance industry. Cost-free
preventive services begin for many
Americans.
 2011: People with Medicare can get key
preventive services for free, and also receive
a 50% discount on brand-name drugs in the
Medicare “donut hole.”
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http://www.hhs.gov/healthcare

10.  2012: Accountable Care Organizations and
other programs help doctors and health care
providers work together to deliver better care.
 2013: Open enrollment in the Health
Insurance Marketplace begins on October 1st.
 2013: Open enrollment in the Health Insurance
Marketplace closes on March 31st.
 Purchase by December 14, 2013 to BEGIN
COVERAGE JANUARY 1, 2014.
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http://www.hhs.gov/healthcare

11.  2014: All Americans will have access to
affordable health insurance options.
 The Marketplace will allow individuals and small
businesses to compare health plans on a level playing
field.
 Middle and low-income families will get tax credits that
cover a significant portion of the cost of coverage.
 Medicaid program will be expanded to cover more low-
income Americans.
 Millions of people who were previously uninsured will
gain coverage, thanks to the Affordable Care Act.
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http://www.hhs.gov/healthcare

12.  There is a fee for not signing up for 2014
insurance
 2014 – The highest amount of
 $95.00 per adult
 $47.50 per child
 1% of your income
 2015 – The highest amount of
 $325.00 per adult
 $162.50 per child
 2% of your income
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Jen Christensen -
www.cnn.com
10/1/2013

13.  Ask current doctors
 Companies accepting in 2014
 Plans they recommend for your needs
 Some may not answer this one
 Does not hurt to ask
 Read coverage carefully
 Preventative
 Outpatient vs. Inpatient
 Out-of-Network vs. In-Network
 Deductibles – What you have to pay
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14.  Flexible Savings Account
 Tax free savings for prescription and copays
 Use it by the end of year or lose the money
 May (or may not) be used for over the counter meds
 Dental and Vision will be separate
 Some plans may have one free annual visit for these
 Check pediatric and young adult coverage
 Prescription Drug Terms
 Generic vs. Name Brand
 Deductible vs. Copay
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15.  Terms – Shared costs with you and insurer
 Coinsurance – Insurer splits costs with you
 Copay – Payment at the time of service
 Before Deductible / After Deductible
 Additional Coverage
 Chiropractic
 Hospice
 Additional Information
 Am Best Rating – Report Card for Insurance Companies
 This rating should not be older than 2 years or lower than a
B+
 NR = Not Rated… stay away from these!
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16.  https://www.healthcare.gov
 Select “Apply Now”
 Select your state and “Apply Now”
 Create a Market place account
 Enter name and email address [mandatory]
 Create a username and password [write down & save]
 Create security questions and provide answers
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http://www.hhs.gov/healthcare

17.  Go to email to receive confirmation of account
 Login using user id and password
 Begin the application process
 Problems or Questions call the Customer Service
Center at 1-800-318-2596
 DO NOT sign up or pay for a policy you are
unsure about!
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http://www.hhs.gov/healthcare

18.  http://www.healthcare.com
 A secondary site for insurance quotes
 Go directly to company websites
 Blue Cross Blue Shield - http://get.bcbsga.com
 Subsidized health plan for students and grads
 Kaiser Permanente – http://www.kp.kaiser.org
 Cigna - http://www.cigna.com
 Other – all companies have websites ready
 Interactive subsidy calculator
 http://kff.org/interactive/subsidy-calculator/
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