It’s showtime for health-care reform
President Barack Obama signed the new health law into effect back in 2010, but its four most momentous changes kick in Jan. 1, 2014, notes Consumer Reports.
Just about everyone in the U.S., with a few exceptions, will be required to have some kind of health insurance.
If they don’t, most will have to pay a penalty at tax time of $95 per adult and up to $285 per family for the 2014 tax year. That escalates to $695 for adults and $2,085 for families in 2016.
The long-standing insurance company practice of turning people down or charging them extra because of pre-existing conditions will be outlawed.
Low- and moderate-income households will get financial help in the form of a new kind of tax credit that they can use right away to help pay for premiums.
A NEW HEALTH MARKETPLACE
The centerpiece of the transformed health care system wrought by the Affordable Care Act is an entirely new way of choosing and purchasing individual health insurance known generically as marketplaces. They opened for business Oct. 1, 2013, in every state, whether the state was willing or not.
Consumer Reports explains what you need to do with the new law, depending on whether you now get insurance:
If you get health insurance through your work or someone else’s, you’ve met your obligation to be insured. Your only job will be to hang onto a couple of forms that you’ll be given. By Oct. 1, 2013, your employer should have given you a form with the catchy name “New Health Insurance Marketplace Coverage Options and Your Health Coverage,” or something similar. Don’t throw the form away. And at some point in early 2015, your insurer will send you a form verifying that you have insurance. You’ll need to submit that when you file your 2014 tax return.
If you buy insurance on your own or don’t have any, the marketplace is designed for people like you. You can’t compare it to anything you have already experienced because it’s an entirely new animal, a centralized resource where you can do the following:
Investigate financial help. Find out whether you qualify for income-based assistance with your premiums, lower out-of-pocket costs or free or almost-free Medicaid. You can still buy private insurance outside the marketplace, but you can qualify for and receive financial assistance only within the marketplace.
Shop for health plans. Compare private insurance plans that offer comprehensive health benefits and meet other qualifications. You’ll be able to see the premiums you would pay, the health care providers who belong to each plan’s network, plan details such as deductibles and co-pays and in some states, quality ratings.
Enroll in a plan. Coverage can start as early as Jan. 1, 2014. You won’t have to provide any information on your health history because insurance companies won’t need it anymore.
Get Medicaid or State Children’s Health Insurance Program. Enroll in Medicaid or SCHIP for your kids if your income qualifies. More people will be eligible for Medicaid in states that are expanding the program, Consumer Reports says.
If you’re on Medicare, you don’t have to do anything or buy anything extra. Medicare Part A and Advantage plans fully qualify as insurance under the new law. And nothing significant about Medicare is changing in 2014. Benefits and programs will work the same as they do now.
But there is one situation in which the new health care law might help: You are a new enrollee and your spouse isn’t on Medicare yet. Once the older spouse retires and enrolls in Medicare, the younger, often nonworking spouse may suddenly be without insurance. The spouse often has a hard time buying an individual policy because of pre-existing conditions. Now the younger spouse can buy a plan on the marketplace and not worry about getting turned down or charged extra because of a pre-existing condition.
2013 Consumers Union Inc.