The Affordable Care Act and You


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This timeline describes the major milestones of the Affordable Care Act and what you need to know as the law is fully implemented in October, 2013. Have questions? We are here for you by phone, online and in person. Go to for more.

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The Affordable Care Act and You

  1. 1. Comparing health plan coverage and costs All insurance companies must show the benefits and costs of their health plans in the same format. This format is called a Summary of Benefits and Coverage. This will make it easier to compare health care plans. Everyone can get a health plan Starting October 1, you can’t be turned down or charged more for insurance even if you are already sick or have a health condition. Rebates from insurance companies Insurance companies must give back a part of the money they collect from premiums if they don't spend a certain amount of it on medical care. Get help understanding health plans This fall Navigators and Certified Agents will be in your community to help you understand Marketplace plans available and what they will cost. They can also help you apply and enroll in a plan. The fee in 2014: pay 1% of your yearly taxable income or $95 per person — whichever is higher. This will increase every year. Must have health plan or pay a fee If someone who can afford health insurance doesn't have coverage in 2014, they may have to pay a fee. They also have to pay for all of their health care. Health Care Reform and You Get preventive care at NO COST The new plans will cover a lot of preventive care services including: This fall people under 30 and some people with limited incomes may buy what is called a "catastrophic" health plan. It protects you from very high medical costs. Lots of changes are happening in health care. We’re here to help you understand what is new and what you may need to do. The health care reform law, called the Affordable Care Act, was passed by our government in 2010. The law makes health insurance available to more people, so more people will be able to get the care they need. That’s good news! Here are some key things to know. 'Metal' health plans offered this fall There will be four categories of health plans: Platinum, Gold, Silver and Bronze. These metal levels can help you compare plans, the monthly premiums, and costs for services for things like doctors or hospital visits. Coverage is effective 1/1/2014. Grandfathered health plans People enrolled in a health plan that took effect before March 23, 2010, may be able to keep their plan. Know your budget. This fall, there will be a lot of health plans to choose from, so you should think about your budget and your needs. Think about the monthly The Marketplace opens: New health plans available Oct. 1 With an effective date of 1/1/2014, you can buy one of the new health plans from an insurance company or through the government’s health insurance Marketplace. Florida Blue or your local insurance agent can also help you understand your choice of plans on the Marketplace, plus other options for health plans through Florida Blue. We can help you apply and enroll. Premium Tax Credits You may be eligible for a tax credit or 'subsidy' to help pay for your health plan through the Marketplace. For 2013, Individuals who make less than $45,960 or families of four that make less than $94,200 may qualify for a subsidy. Cost-sharing reduction If you buy a health plan from the 'Silver' category through the Marketplace and your income is below a certain level, you may get a discount on your health care services. This lowers the amount you'll pay out-of pocket for your health care deductibles, coinsurance and copayments. Bronze cost of the health plan and see what health costs it covers. Usually the lower your deductible, the higher the monthly health plan bill. Silver Gold Platinum Pay to the order of: Medical Loss Ratio(MLR) Rebate Date: Dollars $ Pay to the order of: Medical Loss Ratio(MLR) Rebate Date: Dollars $ How can I learn more about how health care reform affects me? We encourage you to talk to us one-on-one for answers to your specific health insurance questions. We can explain your options and walk through the next steps you may need to take, so you can make the best decisions for you and your family. Call: 1-800-633-6808 or your local insurance agent Visit: a Florida Blue Center – find one near you at Visit our blog at Florida Blue, Florida’s Blue Cross and Blue Shield Company Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 77821-0913R Stay up-to-date 24/7! Just visit our website at Read facts about the health care law and how the changes may affect you, view the top FAQs and more. The Resources section at the bottom of the page has a lot of great interactive tools: a subsidy estimator, an ebook you can download, a fun and educational video library, plus a timeline of key dates. This information is for illustrative purposes only and is being provided to help increase understanding of the impacts of some of the provisions of the Affordable Care Act (ACA). It does not attempt to cover all of the law’s provisions and is not intended as tax or legal advice. We encourage members to seek professional advice including legal counsel, regarding how the new requirements may affect you. Starting October 1, the cost of a health plan will be based on your age, where you live and if you use tobacco. It won't matter if you are male or female or if you have any kind of health condition. Extra help for kids under 19 Starting this fall, all plans for individuals and families will include kid’s vision care and some will include dental care for kid's under age 19. All plans for small businesses will have vision and dental care for kids under 19. DENTAL Essential Health Benefits This fall, all of the new health plans for individuals and small businesses must include a comprehensive list of items and services known as 'Essential Health Benefits'. These include things like emergency services, hospitalization, maternity and newborn care, mental health and substance dependency services, prescription drugs, preventive and wellness services, pediatric dental and vision care. VISION $0 Mammograms, well-woman visits, breast-feeding supplies and support Routine physicals, immunizations, well-child visits Eye exams, lenses and more for children under age 19 Contraceptives Use our subsidy estimator and see if you may qualify by visiting: 2012 2013 2014