Total grasp about the medical insurance could be challenging as it is relatively new and there are issues on its salient points. This article aims to be a friendly guide for dummies to understand what is this all about the health law.
Need to Know Background About Health Insurance
Plenty of Americans still do not health insurance. There is a significant drop in numbers though as statistics shows that only 33 million US citizens do not have insurance for their medical needs compared to the 42 million before the implementation of the Affordable Care Act. Despite this effort, it is difficult to neglect the fact that 18% of the annual national budget or about $3 trillion is allotted for this and yet Medicare cannot meet its financial obligations in the year 2030 based on the expectations. As a result, efforts were made in an attempt to address issues like the Affordable Care Act, also known as the health reform law that was passed in the year 2010.
Salient Points to Understand About the Current Health Insurance Program
You should be aware by now that a healthcare plan is a requirement to almost all Americans. Not following this mandate means you should be ready with the consequence where you need to pay a tax penalty amounting to 2.5% of the taxable income for the year 2016. This mandate was implemented in attempts of the government to convince Americans not to wait to get badly sick before they avail of a health insurance. The states though may avail of the subsidy where the federal government fund will be used to pay for the first three years of the low-income citizens.
Who Are Qualified to Avail of the Help in Insurance Payment
Under the law, it says that a state may choose to expand its Medicaid program and let the federal government pay for people under the low income bracket. How do you know if you are qualified for this? It simply means that you should be a family consisting four members with an income less than $33,465 or an individual that earns less than $16,242. If you are one of these, the government will pay for the first three years of your insurance. Meanwhile, there are also tax credits implemented for individuals whose income is up to $47,000 and for a family of four earning $97,000 annually for the year 2016.
What Is Meant by Marketplaces of Health Insurance
Marketplaces are the way of the government to help you find a health plan that is suited for you and your family. There are states that run their own Marketplaces but in some cases, the federal government handles the said machinery. Based on the blog of the government’s health program, Marketplaces should include the following benefits:
- Emergency Room trips
- Inpatient care
- Outpatient care
- Prescription drugs
- Mental health and substance abuse services
- Pregnancy and newborn care
- Laboratory services
- Habilitative and rehabilitative care
Know the Updated Requisites for Consumer Protection Under Private Insurance
It started in the year 2014 when insurers can no longer charge older people three times more of what young people pay. Insurers are only allowed to charge up to one and one half times in some geographic areas or for those using tobacco. Listed below are the additional consumer protections that you should know of.
- Staying at your parent’s health plan is possible until you reach the age of 26.
- Medicare and preventive care should be available to people under private insurance.
- Insurers may be subjected review if suspected of unreasonable rate increase in the insurance.
- Pre-existing conditions cannot be used to charge more for a premium and they should not be denied health insurance.
New Requirement for Businesses
A penalty is waiting for individuals who will not apply for health plan coverage, and the same goes for businesses who employ more than 50 worker. An establishment should offer its full-time employees an affordable medical care program. A penalty of $2,160 to $3,240 for every full-time worker is the expected penalty for businesses that will not adhere to this.
Proposal on How to Improve the Marketplace
Under the current situation, medical care companies are required to have a license and bond in every state where they conduct operation. There is a call to allow them to conduct operation in any state as long as they meet the standards set on one state.
Understanding all about medical care programs could be a bit hard during its early years of implementation. It would not hurt to read to learn more and know about the different health insurance companies that could provide you the best offer.