Must Know Information About the New Affordable Care Act

The health insurance market has undergone a radical change over the last few years. Gone are the individual coverages, medical underwriting, and pre-existing conditions clauses. President Obama promised sweeping reforms and they're here. But what, exactly, do these reforms mean for you in practical terms?


You Must Buy Insurance


Because the Affordable Care Act, also known as "Obamacare" or the "ACA," places certain requirements on insurance companies and certain groups of people, everyone must own a health insurance policy. You must either obtain insurance through Medicare or through a private insurer. Insurance must meet certain minimum requirements and you must choose a plan that complies with those requirements.


Until the end of this year, some insurers are choosing to sell low cost health insurance that does not meet the requirements of the ACA. This is possible because the mandate on insurance coverages doesn't start until next year - insurers are taking advantage of this to sell plans that are still affordable for those who otherwise wouldn't be able to obtain insurance.


Failure to obtain insurance next year will result in a penalty. Penalties start at $95 per year in the first year, or 1 percent of household income, whichever is larger. Penalties increase each year. Still, it's less than the cheapest premium, which starts at around $200 per month.


Your Insurance Plan Might Be Cancelled


Your current insurance plan might be cancelled if it does not meet the requirements of the ACA. Recently, the president issued an announcement stating that individuals could keep their health insurance if they wished to do so, even if it did not comply with the requirements of the ACA.


Still, some insurers are dropping coverage because it's just not worth the additional costs to maintain the policy in the face of new government regulations.


Your Kids Can Stay On Your Policy Until They're 26


Your children are allowed to stay on your policy until the age of 26. This gives them coverage they need, though you will have to pay for it. Still, young people often find it difficult to afford insurance, so this is one way to keep young people insured without burdening them with bills they cannot yet afford.


Insurers Cannot Reject You Due To Pre-existing Conditions


In the past, insurance companies could deny coverage based on pre-existing conditions. Usually, the insurer would not outright deny you coverage. Instead, they would simply deny any claims relating to any pre-existing conditions you had. Even still, denial of coverage for those conditions was temporary, with insurers generally reinsuring those conditions after a period of 18 months.


Now, however, insurers must cover you from day one - you cannot be denied service or coverage for any pre-existing condition. The day you are approved for insurance coverage, you can use it.


Expect Changes Between Doctors and Insurers


Not everything in the health insurance law is rainbows and sunshine. Some insurers are changing their relationships with doctors due to the essential coverages they must now provide. In order to remain profitable, some doctors are being excluded from insurers' networks. This means you may end up losing your doctor. You'll have to choose a new doctor from the list of participating providers in your insurer's network. That's because health insurance today works by contracting with doctors and hospitals for services.


If you don't use a regular or primary care physician, this isn't going to be a big deal. If you do, there are a lot of changes in your future.


Lewis Brooks is an experienced healthcare professional. He particularly enjoys writing about changes and innovations in the industry.







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