The Patient Protection and Affordable Care Act, more commonly known as Obamacare, is making headlines because of the looming vote scheduled in the Senate next week. The controversy surrounding this bill has so far been the main focus of the media, leaving many Americans questioning what this entails for them when it is passed.
Employer-based health insurance
If your employer provides your health insurance, do not panic. Changes mandated by the ACA are mostly already in effect. For example, preventive care will be offered for free with no co-pay or deductible required. Lifetime caps on coverage are also banned, and insurance companies are no longer allowed to let go of an employee when they are sick.
Other than that, the right to change policies, premiums, and deductibles still remain with employees.
If you are covered by Medicare, the main change that you will see is the narrowing of the gap in prescription drug coverage. Currently, Medicare cites that after paying an initial amount for covered drugs, you have to pay all costs out-of-pocket up to a yearly limit before the gap ends and the coverage is activated again.
The ACA is now requiring that this gap become smaller over time and be completely closed by the year 2020.
Medi-Cal is a welfare program in California (called Medicaid in other states) that is designed to help low-income families receive much needed health care. Unfortunately, not everyone living under the poverty line is eligible for Medi-Cal.
With the ACA, this program will be expanded to cover more people. This means that anyone earning up to $15,850 a year or $32,500 for a family of four will be eligible to receive Medi-Cal starting January 1, 2014.
In addition, individuals who are under the Low Income Health Program will also transition into Medi-Cal effective next year.
If you purchase your own private health insurance, the you are likely familiar with the current regulations enacted by insurance companies. For example, if you have a pre-existing condition, they will give you a higher premium or even refuse to cover you.
Starting January 1st, however, those practices will no longer be allowed. Rates will not be based on your health history, but rather your age, where you live, and the number of members in your family.
There will also be a new online marketplace called Covered California that will be launched on October 1 of this year. Through this program, consumers can choose and compare insurance plans from different insurance carriers with the assurance that all the plans posted meet the requirements of the law.
If you are not insured, then you may be required to get some or pay a fine. During the first year, the penalty will be $95 per person or 1 percent of your income, depending on which amount is greater.
To get insurance, you can either be part of Covered California or Medi-Cal. Your income will determine which program you will be eligible for.
Illegal immigrants are exempt from this requirement and the penalty fee, but will also not be eligible to receive any benefits under the ACA. Green card holders, on the other hand, will receive the same benefits as American citizens.
Whichever category you belong, it is important to be aware and to be prepared of the changes brought upon by the Affordable Care Act.