Affordable Care Act For Individuals and FamiliesPresentation Transcript
TheAffordable Care ActWhat It Means For You and Your Family
What We’ll Cover:What Is the Affordable Care ActHow Will the Affordable Care Act Impact HealthCoverage Choices and OptionsYour Call To Action
What is it?Affordable Care Act:The comprehensive health care reform law enacted inMarch 2010. The law was enacted in two parts:The Patient Protection and Affordable Care Act wassigned into law on March 23, 2010 and was amended bythe Health Care and Education Reconciliation Act onMarch 30, 2010.The name “Affordable Care Act” is used to refer to thefinal, amended version of the law.On June 28, 2012 the Supreme Court rendered a finaldecision to uphold the health care law.http://www.healthcare.gov/glossary/a/affordable-care.html
Who is Affected?• American citizens• American nationals• Aliens legally present
What’s Coming?Coming in 2014Individuals musthave basic coveragealso known asMinimum EssentialCoverage;Or be eligible for aqualifyingexemption;Or pay a sharedresponsibility cost onannual income tax.
What is Minimal EssentialCoverage?Minimum Essential Coverage:The type of coverage an individual needs to have, tomeet the individual shared responsibility requirementunder the Affordable Care Act.
Individual Shared Responsibility• Everyone shares responsibility under the AffordableCare Act• Each individual must ensure they have minimumessential coverage• All individuals are included regardless of age –everyone must have coverage or an exemption, ormust make a payment on individual income tax
What Qualifies as MinimalEssential Coverage?• Employer sponsored coverage including COBRA, andretiree coverage plans• Coverage purchased in the individual insurancemarketplace• Medicare Part A• Medicaid• Peach Care for Kids• Children’s Health Insurance Program (CHIP)• Some veterans’ health coverage plans• TRICARE
What’s Not Required forMinimum Essential Coverage?• Vision Only Plans• Dental Only Plans• WorkersCompensationPlans• Special Coveragefor SpecificConditions
What Is a Qualifying Exemption?• Religious Conscience• Health Care SharingMinistry• Indian Tribes• No Filing Requirements• Short Coverage Gap• Hardship• Unaffordable CoverageOptions• Incarceration• Not Lawfully Present
How to Qualify For An Exemption• Certificate through Health Insurance Marketplace ifseeking exemption based on religion or hardship.• Elect status on income tax return if seeking exemptiondue to legal status, low income, affordability or coveragegaps.• Choose either method (certificate or tax return) if seekingexemption based on health care sharingministry, incarceration or member of an Indian tribe.• If you are not required to file income taxes you areautomatically exempt and do not need to be certified bythe exchange.
What Do You Need To Do?If you have coverage and are happy with yourcoverage you don’t need to take any action.
What Do You Need To Do?• If you do not havecoverage• If you want toexplore youroptions• If you plan onterminating yourcurrent coverageHealthInsuranceMarketplace
What Do You Need To Do?Open enrollment beginsOctober 1, 2013Coverage begin on Jan 1, 2014
How Much Will This Cost?• Manypeople/families willbe able to qualifyfor free or low costinsurance• Others may beeligible for a taxcredit to reduce thecost of premiums
Free and Low Cost Options• Private insurance options• Insurance finder tool to help you identify options thatare affordable www.healthcare.gov• Low premiums• Low out-of-pocket costs• Coverage for pre-existing health conditions• Network of community health centers that providepreventive and primary care for free or on a slidingscale.• American Indians and Alaska Natives may beeligible through the Indian Health Services programwww.ihs.gov
Tax Credits• Tax credit foreligible individualscan be appliedright away tolower monthlypremiums• Application for taxcredit can becompleted duringopen enrollment• Eligibility basedon income andfamily size
Medicaid ExpansionBeginning in 2014most adults underage 65 with incomeless than$15,000/year willqualify for Medicaid inevery state
Medical Loss Ratio RebatesInsurance companies must spend at least80% of premium dollars on medical care, orthey must provide a rebate to policy holdersat the end of the year.
Other Changes• Flexible Spending Accounts (FSA) contributionslimited by the government to a $2,500 max• High income earners ($200,000 single or $250,000married) saw a 0.9% increase in Medicarewithholding in 2013• Beginning in 2013 there is a 38% Medicare taxbeing assessed on certain types of investmentincome
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