As the deadline approaches to sign up for health care coverage under Obamacare, more people are asking- what is it and what does it mean for me? With Obamacare’s implementation in the news each day, I thought it might be helpful to provide an overview of Obamacare’s key points.
Generally speaking, Obamacare is a combination of measures to control health care costs while also ensuring coverage for all who apply. Individuals must apply for health insurance coverage or pay a fine, unless they are covered under an employer-sponsored plan. The version of Obamacare in California is called Covered California. The requirement to enroll is effective January 1, 2014.
While issues with signing up are still being worked out, there are many positive features to the new coverage. The new insurance plans cannot charge women more than men for the same coverage, those with incomes below 400% of the federal poverty levels will receive assistance with their policy premium payments and mental health treatments will be covered now just like physical health treatments (called “parity”). Here are some additional facts that I found helpful:
- Open enrollment period for 2014 coverage is October 1, 2013 until March 31, 2014. If you don’t enroll during this period, you will not be covered for 2014 and you will have to wait until October 15, 2014 to sign up for 2015 coverage.
- There are four levels of coverage: platinum, gold, silver and bronze. The new health plans fall into one of these four levels based on the percentage of medical expenses paid under the plan.
- For those that cannot afford one of the levels of coverage, even with government assistance, you can apply for “catastrophic coverage” if you are able to show a hardship. This coverage still allows for three doctor’s visits/per year and other preventative care.
- Covered California provides some dental work for children as part of the general coverage.
The most important features to emphasize here is that no one can be denied insurance coverage due to pre-existing conditions and there can no longer be annual caps or lifetime caps on coverage.
Some of my younger clients have reported that they may be paying a bit more under the new plans, but they also now have the type of insurance to give them the peace of mind if one of their family members ends up in the emergency room while also covering preventative care costs for their entire family. My clients who are retired or semi-retired are reporting a reduction in their premium costs. If you have any questions about this post or the services I provide my clients, please contact us to learn more.
Please note that this article is a basic summary. I encourage my readers to go to the Covered California website to learn more. Also, a big thank you to Sara Senger for her presentation on this topic, which largely contributed to this article.