The Affordable Care Act: What It Means For You

Over the past decade, health care costs have risen dramatically for families. In addition, insurance companies have been able to deny and restrict coverage to members. New rules under the ACA give more rights to patients and helps slow the rising costs of care for families.

Wondering what it means for you? Use the table below to help you understand your new rights under the ACA.

  NEW RIGHTS
EMPLOYER PAID INSURANCE 1.No lifetime limits on benefits2.Phase out annual benefit limits3.Insurers can’t cancel coverage if member gets sick

4.Preventative screenings covered in full

 

MEDICARE 1.Preventative screenings, immunizations and annual exams covered in full2.Graduated closing of “donut” hole to reduce Rx payments3.Medicare will increase payments to providers, meaning more doctors should participate in the program

4.Medicare will target practitioners who abuse and fraud the system

 

 

POOR AND UNINSURED 1.Some states are changing Medicaid eligibility rules to insure more people under the program.2.The government will offer subsidies to help those with incomes up to 400% of the Federal poverty level purchase private insurance through insurance exchanges.3.No household should pay more than 10% of annual income on health insurance.

 

UNDER 26 YEARS OLD 1.Children can remain on a parent’s plan until age 262.Adult children do not need to be a dependent3.Does not extend to spouse or child of an adult child

 

PRE EXISTING CONDITIONS 1.Pre-existing Condition Insurance Plan (PCIP) are available to those uninsured for at least 6 months and who have been denied coverage because of a pre-existing condition.2.Premiums will vary by age, but not by health status. Tied to average rates for healthy individuals by state.