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Reforms under the Affordable Care Act have brought an end to some of the worst abuses of the insurance industry. These reforms have given Americans new rights and benefits, by helping more children get health coverage, ending lifetime and most annual limits on care, allowing young adults under 26 to stay on their parent’s health insurance, and giving patients access to recommended preventive services without cost.
For more information, visit: http://www.healthcare.gov/foryou/conditions/index.html. |
Many other new benefits of the law have taken effect, including 50% discounts on brand-name drugs for seniors in the Medicare “donut hole,” and tax credits for small businesses that provide insurance to employees. More rights, protections and benefits for Americans are on the way through 2014.
Find out how the law provides better benefits and better health.
Individuals with health conditions have more affordable options for health coverageIf you have a health condition, you know how important having health insurance is and how expensive it can be. Worrying about where to get coverage and the cost of your care is the last thing you want to do when you are dealing with chronic illness. The Affordable Care Act is expanding your options for health insurance and making them more affordable. A new program helps uninsured people with pre-existing medical conditions find coverage options.Find out whether you qualify and learn how to apply.
Find out how the law provides better benefits and better health.
Individuals with health conditions have more affordable options for health coverageIf you have a health condition, you know how important having health insurance is and how expensive it can be. Worrying about where to get coverage and the cost of your care is the last thing you want to do when you are dealing with chronic illness. The Affordable Care Act is expanding your options for health insurance and making them more affordable. A new program helps uninsured people with pre-existing medical conditions find coverage options.Find out whether you qualify and learn how to apply.
- Under the Affordable Care Act, if you have been uninsured for at least six months and have a health condition, you may be able to get health insurance through the Pre-Existing Condition Insurance Plan.
- If a new insurance plan doesn’t pay for services you believe were covered, you now have new, clear options to appeal the decision.
- Insurance companies can no longer drop you if you get sick just because you made a mistake on your coverage application.
- Starting in 2014, job-based and new individual plans won’t be able to exclude you from coverage or charge you a higher premium for a pre-existing condition, including a disability.
- Starting in 2014, if your income is less than the equivalent of about $88,000 for a family of four today, and your job doesn’t offer affordable coverage, you may get tax credits to help pay for insurance.
Healthy individuals have more affordable options for health coverage
Even if you’re healthy now, sooner or later there will come a time when you will need health insurance. Not having health insurance when you need it can result in large amounts of debt and bad credit ratings. Worrying about health insurance and the cost of your care is the last thing you want to do. The Affordable Care Act is expanding your options for health insurance and making them more affordable
Top 5 Things to Know
For more information, visit: http://www.healthcare.gov/foryou/healthy/index.html.
Strengthening MedicareThe new law extends the life of the Medicare Trust fund at least 12 years, and takes other actions to secure the program. The Affordable Care Act strengthens Medicare and helps seniors take charge of their health. The law provides important benefits such as free preventive services, free annual wellness visits, and a 50% discount on prescription drugs for Medicare recipients in the coverage gap known as the "donut hole." You can also work with your doctor to create a personalized prevention plan.
For more information, visit: http://www.healthcare.gov/foryou/seniors/index.html.
People with DisabilitiesPeople with disabilities have more affordable options for health coverage. If you’re living with a disability, private health insurance may be hard to come by. Even if you can afford to buy it, it probably doesn’t cover all of your needs. Worrying about where to get coverage and the cost of your care is the last thing you want to do. The Affordable Care Act is expanding your options for health insurance and making them more affordable.
For more information, visit: http://www.healthcare.gov/foryou/disabilities/index.html.
Families with children have more affordable options for health coverageYou do your best to keep your children healthy, but sickness and accidents are a part of life. Getting health insurance for your children gives you peace of mind knowing they have health coverage when they need it. But for many hardworking families, affordable insurance can be hard to find. The Affordable Care Act is giving you more control over your family’s health care by expanding your options for health insurance and making them more affordable.
For more information, visit: http://www.healthcare.gov/foryou/family/index.html.
Women
The Affordable Care Act offers important benefits to women, recognizing that women have unique health care needs and are often health care decision makers in their households. Read this section to get pregnancy and breastfeeding information and to learn about how the Affordable Care Act affects women. Women have unique health care needs, and often make health care decisions for their families. The law offers important benefits for women and their families.
For more information, visit: http://www.healthcare.gov/foryou/women/index.html.
Young Adult Coverage until Age 26
Under the Affordable Care Act, if your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 years old.
What This Means for You
Until now, health plans could remove enrolled children usually at age 19, sometimes older for full-time students. Now, most health plans that cover children must make coverage available to children up to age 26. By allowing children to stay on their parent's plan, the Affordable Care Act makes it easier and more affordable for young adults to get health insurance coverage.
Your adult children can join or remain on your plan whether or not they are:
Providing Free Preventive Care
Effective for health plan years beginning on or after September 23, 2010 All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.
Under the Affordable Care Act, you and your family may be eligible for some important preventive services—which can help you avoid illness and improve your health—at no additional cost to you.
What This Means for You
If your plan is subject to these new requirements, you may not have to pay a copayment, co-insurance or deductible to receive recommended preventive health services, such as screenings, vaccinations and counseling.
For example, depending on your age, you may have access at no cost to preventive services such as:
Some Important Details
For more information, visit:http://www.healthcare.gov/law/provisions/preventive/index.html.
Even if you’re healthy now, sooner or later there will come a time when you will need health insurance. Not having health insurance when you need it can result in large amounts of debt and bad credit ratings. Worrying about health insurance and the cost of your care is the last thing you want to do. The Affordable Care Act is expanding your options for health insurance and making them more affordable
Top 5 Things to Know
- Under the Affordable Care Act, insurance companies can no longer drop you when you get sick just because you made a mistake on your coverage application.
- Parents have new options to cover their children. If you have children under age 26, you can insure them if your policy allows for dependent coverage. The only exception is if you have an existing job-based plan, and your children can get their own job-based coverage.
- Job-based health plans and new individual plans are no longer allowed to deny or exclude coverage to any child under age 19 based on health conditions, including babies born with health problems.
- Starting in 2014, if your income is less than the equivalent of about $88,000 for a family of four today and your job doesn’t offer affordable coverage, you may get tax credits to help pay for insurance.
- Starting in 2014, if your employer doesn’t offer insurance, you will be able to buy insurance directly in an Exchange that gives you power similar to what large businesses and members of Congress have to get better choices and lower prices. An Exchange is a new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans. Exchanges will offer you a choice of health plansthat meet certain benefits and cost standards. Starting in 2014, Members of Congress will be getting their health care insurance through Exchanges, and you will be able buy your insurance through Exchanges, too.
For more information, visit: http://www.healthcare.gov/foryou/healthy/index.html.
Strengthening MedicareThe new law extends the life of the Medicare Trust fund at least 12 years, and takes other actions to secure the program. The Affordable Care Act strengthens Medicare and helps seniors take charge of their health. The law provides important benefits such as free preventive services, free annual wellness visits, and a 50% discount on prescription drugs for Medicare recipients in the coverage gap known as the "donut hole." You can also work with your doctor to create a personalized prevention plan.
For more information, visit: http://www.healthcare.gov/foryou/seniors/index.html.
People with DisabilitiesPeople with disabilities have more affordable options for health coverage. If you’re living with a disability, private health insurance may be hard to come by. Even if you can afford to buy it, it probably doesn’t cover all of your needs. Worrying about where to get coverage and the cost of your care is the last thing you want to do. The Affordable Care Act is expanding your options for health insurance and making them more affordable.
For more information, visit: http://www.healthcare.gov/foryou/disabilities/index.html.
Families with children have more affordable options for health coverageYou do your best to keep your children healthy, but sickness and accidents are a part of life. Getting health insurance for your children gives you peace of mind knowing they have health coverage when they need it. But for many hardworking families, affordable insurance can be hard to find. The Affordable Care Act is giving you more control over your family’s health care by expanding your options for health insurance and making them more affordable.
For more information, visit: http://www.healthcare.gov/foryou/family/index.html.
Women
The Affordable Care Act offers important benefits to women, recognizing that women have unique health care needs and are often health care decision makers in their households. Read this section to get pregnancy and breastfeeding information and to learn about how the Affordable Care Act affects women. Women have unique health care needs, and often make health care decisions for their families. The law offers important benefits for women and their families.
For more information, visit: http://www.healthcare.gov/foryou/women/index.html.
Young Adult Coverage until Age 26
Under the Affordable Care Act, if your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 years old.
What This Means for You
Until now, health plans could remove enrolled children usually at age 19, sometimes older for full-time students. Now, most health plans that cover children must make coverage available to children up to age 26. By allowing children to stay on their parent's plan, the Affordable Care Act makes it easier and more affordable for young adults to get health insurance coverage.
Your adult children can join or remain on your plan whether or not they are:
- married;
- living with you;
- in school;
- financially dependent on you;
- eligible to enroll in their employer’s plan, with one temporary exception: Until 2014, “grandfathered” group plans do not have to offer dependent coverage up to age 26 if a young adult is eligible for group coverage outside their parents’ plan.
- Your plan is required to provide a 30-day period—no later than the first day of your plan’s next “plan year” or “policy year” that begins on or after September 23, 2010—to allow you to enroll your adult child. Your plan must notify you of this enrollment opportunity in writing.
- If you enroll your adult child during this 30-day enrollment period, your plan must cover your adult child from the first day of that plan year or policy year
Providing Free Preventive Care
Effective for health plan years beginning on or after September 23, 2010 All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.
Under the Affordable Care Act, you and your family may be eligible for some important preventive services—which can help you avoid illness and improve your health—at no additional cost to you.
What This Means for You
If your plan is subject to these new requirements, you may not have to pay a copayment, co-insurance or deductible to receive recommended preventive health services, such as screenings, vaccinations and counseling.
For example, depending on your age, you may have access at no cost to preventive services such as:
- Blood pressure, diabetes, and cholesterol tests
- Many cancer screenings, including mammograms and colonoscopies
- Counseling on such topics as quitting smoking, losing weight, eating
- healthfully, treating depression and reducing alcohol use
- Routine vaccinations against diseases such as measles, polio or meningitis
- Flu and pneumonia shots
- Counseling, screening, and vaccines to ensure healthy pregnancies
- Regular well-baby and well-child visits, from birth to age 21
Some Important Details
- This preventive services provision applies to people enrolled in job-related health plans or individual health insurance policies created after March 23, 2010. If you are in such a health plan, this provision will affect you as soon as your plan begins its first new “plan year” or “policy year” on or after September 23, 2010.
- If your plan is “grandfathered,” these benefits may not be available to you.
- If your health plan uses a network of providers, be aware that health plans are only required to provide these preventive services through an in-network provider. Your health plan may allow you to receive these services from an out-of-network provider, but may charge you a fee.
- Your doctor may provide a preventive service, such as a cholesterol screening test, as part of an office visit. Be aware that your plan can require you to pay some costs of the office visit, if the preventive service is not the primary purpose of the visit, or if your doctor bills you for the preventive services separately from the office visit.
- If you have questions about whether these new provisions apply to your plan, contact your insurer or plan administrator. If you still have questions, contact your State insurance department.
- To know which covered preventive services are right for you—based on your age, gender, and health status—ask your health care provider.
For more information, visit:http://www.healthcare.gov/law/provisions/preventive/index.html.
