Next year is the year for the Patient Protection and Affordable Care Act, commonly known as Obamacare because the most significant parts of this health reform law don’t become effective until 2014.
Some of the impacts of this new law include:
- Everyone in the U.S. must be covered
- Higher availability of coverage for U.S. citizens and legal residents
- You cannot be denied coverage if you have a pre-existing medical condition
- Insurance companies must print plain language summaries of benefits and coverage
- Subsidies for low-income U.S. citizens and legal residents to buy health insurance
- All plans offered in the marketplace must include the same essential health benefits
- Health insurance companies can no longer charge higher rates based on gender or existing medical conditions
- If you’re relatively new to your job, the insurance company cannot impose a waiting period of more than 90 days before you earn your health insurance coverage
So, now is the time to really understand the basics of Obamacare.
What is Obamacare?
The complete name of the law is the Patient Protection and Affordable Care Act, and it is a United States federal statute signed into law by President Barack Obama on March 23, 2010. It represents one document of a complete regulatory overhaul of the U.S. healthcare system.
The following facts will help you understand what you need to know about Obamacare:
- Starting January 1, 2014, most Americans must have health insurance through private insurance, their employer, Medicaid, or Medicare (for those over 65).
- The first enrollment period is from October 1, 2013 to March 30, 2014 (future enrollment periods will be shorter).
- Each state will have at least one health insurance exchange that will act as an insurance marketplace where insurance providers will offer health care plans for consumers to buy.
- If the cheapest qualifying health care plan you can buy costs more than 8% of your income after tax credits and subsidies, you are exempt from purchasing a health plan and should apply for Medicare or Medicaid.
- While the Affordable Care Act does not apply to people who are not legal residents, visitors to the U.S. cannot expect free health care because it doesn’t exist.
- The penalty for U.S. residents who do not have health insurance starts at $95 or 1% of your income, whichever is higher. This penalty will increase every year.
- Young adults can stay on their parents’ health insurance plan until age 26 even if they are married, working, and/or living on their own.
- You can no longer be excluded from buying health insurance or be charged more than a healthy person of the same age if you have a pre-existing medical condition.
- Co-payments for routine preventative care such as physicals, cancer screening, and immunizations are no longer valid.
So those are the basics; now, let’s take a look at how Obamacare will affect you.
How will Obamacare affect you?
- If you’re insured through your employer – if you currently have health insurance through your employer, you won’t need to do anything and your employer has probably already made changes to your coverage, including:
- Expanded no-cost preventative care for vaccinations, diabetes and cancer screenings, alcohol abuse, and more
- No annual or lifetime limits on essential health benefits
- If you’re insured on your own - if you’re covered under a private health insurance policy, the health care coverage you have will be updated in January 2014 to include the protections defined in the new law. You can keep your current plan or shop around for a new one in the health insurance exchanges.
- If you’re a Medicare beneficiary – if you’re already covered under Medicare you don’t need to take any action because there are no changes.
- If you’re not insured for health care – if you do not have insurance and you are a U.S. citizen or legal resident, you now have more options than ever for getting health insurance and insurance companies can no longer deny you coverage if you have a medical condition and there are no qualifying tests to pass to obtain coverage. See the HealthCare.gov webiste, select your state, and start finding health care insurance you can afford.
If you are not a legal resident or citizen of the U.S., Obamacare does not affect you, but you will be required to pay for any medical treatment you receive in the U.S. through a visitors insurance plan or out of pocket. It is for this reason that many visitors to the U.S. are making sure they have adequate coverage because there is no free health care in the U.S.
How to Get and Pay for Healthcare
Beginning October 1, 2013 you have the opportunity to shop around and enroll in the new healthcare plans available in the marketplace in your state – this is true even if you are already covered through your current employer.
There are two types of federal financial aid that may be available to you depending on your income, family size, where you live, and whether you are a U.S. citizen or legal resident of the U.S. Again, October 1, 2013 is the magic date because you can apply for federal financial help after that date.
Financial help through the U.S. federal government is only available to U.S. citizens and legal residents and only when the insurance is purchased through the health insurance marketplace. Income guidelines apply.
What Obamacare is Not
To fully explain Obamacare, it’s important to make clear what it is not. Obamacare is NOT:
- A new free healthcare system
- A government provided health care system.
- A replacement for health insurance.
- A way to skip paying for your health care and medical services.
- A new set of government-run hospitals or health services.
In short, Obamacare is not taxpayer-supported health care for anyone who needs medical treatment. Everyone is required to have a proper medical insurance. If you do not have one, Get One.
Disclaimer: Information presented here is high level and for your convenience only, it may not be accurate and may not cover all aspect of the ACA or Obama care act. The ACA law is not fully implemented yet, definitions, eligibility etc. are subjective and may vary from state to state. You may contact a qualified licensed health insurance agent in your area to discuss your specific situations and options. You may also write to us at support[at]visitorscoverage.com.