Monday, September 17, 2012

The Affordable Care Act - How Does it Benefit You?

Cut through the misinformation that is circulating around the Affordable Care Act – “Obamacare” – and make sure you understand what it means to you, your families and your contract. Here is a timeline of some key features of the new law. 

  • No More Lifetime Coverage Limits – Insurers can no longer limit the total dollar amount they will pay over a person’s lifetime
  • Key Insurance Reforms – Insurance companies can no longer deny coverage to a customer because of a paperwork error or unintentional mistake. Consumers also have new options to appeal an insurance company’s decisions
  • Coverage Extended to Young Adults – Young adults may be covered by their parents’ insurance until age 26 if the young adult’s employer does not offer insurance. 3.1 million young adults are benefitting. 
  • No More Refusing Children Coverage Based on Pre-Existing Conditions – This provision will extend to all Americans in 2014. 
  • No More Limits for Essential Benefits – Insurers may no longer set an annual limit for the amount they will pay for certain benefits, such as hospitalization, maternity, newborn care and prescription drugs, that are considered essential. These maximums will be entirely eliminated in 2014. 
  • Closing the “Donut Hole” – Roughly four million seniors who reached this gap in Medicare prescription drug coverage received a tax-free rebate check to help cover expenses. 
  • Provides Small Businesses Health Insurance Tax Credits 
– Small businesses are now eligible for the first phase of a new tax credit for employees’ health insurance. Four million small businesses are eligible to receive this tax credit. 
  • Free Preventative Care – All new plans must cover certain preventative services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance
  • Expanding Coverage for Early Retirees – A five billion dollar program is providing needed financial help for employment based plans to continue to provide valuable coverage to people who retire between the ages of 55 and 65, as well as spouses and dependents. 

  • Help for Seniors – Seniors who reach the coverage gap will receive a 50 percent discount when buying Medicare Part D covered brand name prescription drugs. The “donut hole” will ultimately be phased out, keeping millions of seniors from facing rising prescription costs. Certain preventative services, such as wellness visits and personalized prevention plans for seniors on Medicare are now being provided for free. Nearly 33 million seniors are already benefitting. 
  • Lowering Healthcare Premiums – The law requires that 85 percent of all premium dollars be spent on services or healthcare quality improvement (80 percent for smaller employers). If goals are not met because administrative costs are too high, insurance companies must provide rebates for consumers. This requirement amounts to more than a billion dollars back in the hands of individuals and businesses as a rebate from insurance companies.

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