A new year always brings change – and that’s especially true in 2014 as many aspects of the Affordable Care Act (ACA), or “Obamacare,” take effect Jan. 1.
Designed to increase health insurance’s quality and affordability, lower the number of uninsured people through expansion of public and private insurance coverage and reduce healthcare costs for both individuals and the government, the ACA will radically change the health insurance landscape.
Here’s a look at six important changes:
•Coverage begins in the Health Insurance Marketplace. The Marketplace is designed to be a place to find health coverage. With a single application, you can find out if you can get lower costs based on your income, compare your coverage options and enroll. Applications may be made online, by mail, over the telephone or in person.
Do note that the open enrollment period ends March 31, 2014. For more information, check out HealthCare.gov.
The Marketplace can also tell you if you qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP).
•Coverage for pre-existing conditions. Those with pre-existing health conditions won’t be charged more by a health insurance plan. Coverage can’t be refused, even for those who have been denied coverage in the past due to pre-existing conditions.
However, grandfathered health insurance purchased by an individual, rather than an employer, is the exception to this rule. Under those circumstances, people with pre-existing conditions do not have to be accepted.
•Potential savings on monthly premiums and out-of-pocket costs. Depending upon your estimated 2014 household income and size, you might qualify for lower costs on health coverage via healthcare tax credits, lower out-of-pocket costs or low-cost healthcare through Medicaid.
HealthCare.gov offers a chart that will tell if savings are available to you.
•Medicaid expansion. Medicaid qualification is based on income and family size, with those eligible receiving free or low-cost care (without needing to purchase a plan from the Marketplace).
Medicaid programs must follow federal guidelines and do vary by state, although most states offer coverage for adults with children below a certain income level, pregnant women, some seniors and people with disabilities.
Starting in 2014, more people than ever will qualify for Medicaid. Visit your state’s Medicaid website to find out if you qualify or fill out a Health Insurance Marketplace application.
•No more yearly limits on coverage. Under the new laws, once you’re enrolled, insurance companies are prohibited from adding yearly limits and lifetime coverage limits for health benefits considered essential.
There are a couple exceptions. Insurers can still place yearly and lifetime dollar limits on services that aren’t considered essential benefits for health. Temporary waivers may have been issued for some plans, temporarily exempting them yearly dollar limits rules.
•Expanded small business tax credit. Those with less than 25 full-time employees averaging $50,000 annually or less may qualify for employer healthcare tax credits. To qualify, the employer must pay at least half of its full-time employees’ premium costs. Visit IRS.gov to find out if you qualify or consult with your tax advisor or accountant.
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