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How Does ObamaCare Affect You?

Health Reform.jpgSince its enactment in 2010, the Patient Protection and Affordable Care Act, also known as ObamaCare, has been steadily changing health care throughout the country. By the time it is fully implemented in 2014, every American will be affected. While the reform’s aspects are expansive – and seemingly complex – it is important to understand how its changes affect you and your family.

ObamaCare’s goal is to provide affordable, quality health care to all Americans. To do this, the following are some of the changes taking place in our country’s health care system:

New Protections: Health insurance policies used to have lifetime limits on how much insurance companies would pay for an individual’s medical bills. This often meant people with serious or long-term illnesses would go into debt because their coverage would run out. Now, these lifetime limits are illegal. Additionally, if you get sick or have a pre-existing condition, insurers can no longer choose to cancel or deny your policy. 

However, it is important to note that insurers still can place limitations on other aspects, such as length of hospital stays and office visits, and you should review your specific policy to know what restrictions apply to you. 

Broader Benefits: To help keep long-term medical costs down, ObamaCare focuses on making prevention and primary care accessible to all. Now, all preventive care and annual check-ups are fully covered at no cost to you within your health plan’s network. Examples of preventive care include free cancer screenings, wellness visits, personalized prevention plans, vaccines and flu shots. Additionally, the cost share will be waived for certain prescriptions, such as birth control, should your program allow it. 

Expanding Coverage: Under ObamaCare, millions more seniors on Medicare are going to be able to afford their prescriptions. This is because the reform is striving to eliminate the “donut hole”, which has hindered many seniors’ ability to purchase necessary prescriptions. In addition, children can stay on their parents’ health plans until age 26. This gives them more time to establish themselves financially before taking on the responsibility of paying for their own insurance. 

However, many people are concerned about how these changes affect them financially. Beginning in 2014, an “individual mandate” will require most Americans to have qualifying health insurance or possibly pay a tax if they do not comply. The reasoning? Because insurers cannot exclude anyone, regardless of pre-existing conditions, not requiring insurance would drive the cost of coverage up even higher, according to Consumer Reports.

Visit the NFIB for more information about the mandate and its exemptions.

So, how is ObamaCare striving to make the required health care affordable?

Personal Tax Breaks: Many Americans will receive tax breaks when purchasing health insurance on the upcoming online marketplaces called the ObamaCare Exchange. Shoppers will be able to use a price calculator to find the best deal for them and their families. Furthermore, the marketplaces will streamline and simplify the application process.

New Discounts: For those who qualify, discounts and subsidies will be offered to help pay medical expenses. Medicaid will be offered to more individuals, and young adults in particular will have more options to afford care. For example, they will be able to buy subsidized private insurance or health plans that cover essential benefits and three primary care visits a year. While these plans may have higher cost-sharing expenses for certain services, annual premiums are likely to be lower. 

To get an estimate of the discount you might have coming to you and review your qualifications, visit the Kaiser Family Foundation.

However, it is important to note that ObamaCare’s changes are ongoing and not fully implemented as of 2013. Therefore, for individuals whose employers do not offer insurance or are self-insured, it is a good idea to discuss options for personal health insurance policies with your insurance agent.

Vargas & Vargas Insurance is committed to helping you understand and meet all of your insurance needs. Call today at 877-550-0025 and work with one of our agents to get the coverage you need at a price you can afford.

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