HHM Finance Night - Affordable Healthcare 2013

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Basic information to help understand requirements for 2013 Affordable Healthcare initiative.

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HHM Finance Night - Affordable Healthcare 2013

  1. 1. 1 AFFORDABLE HEALTHCARE ACT 2013 Presented by: Jennoa R. Graham, Ph.D. Friday, October 11, 2013
  2. 2.  Affordable Healthcare Website  Highlight website areas for review  Key Features  Benefit Specific  Yearly Breakdown  Penalties 2 http://www.hhs.gov/healthcare
  3. 3.  Selection Tips  Application  Additional Resources 3 http://www.hhs.gov/healthcare
  4. 4.  http://www.hhs.gov/healthcare  Links to follow  About the Law  Prevention and Wellness  Facts and Features  Read everything  Set aside at least 2 hours  If the lettering is blue, click it for more information  If you get lost.. Click “Home” under Insurance Marketplace 4 http://www.hhs.gov/healthcare
  5. 5.  On March 23, 2010, President Obama signed the Affordable Care Act. The law puts in place comprehensive health insurance reforms that will roll out over four years and beyond.  Designed for %15 of Americans who do not have health insurance. Rates/subsidy income based.  NOT for Americans that have insurance through their place of employment or Medicare.  Law prohibits lifetime or annual limits for benefits; review 2014 plans carefully for any terms like “exclusions or “grandfathered” in the text. 5 http://www.hhs.gov/healthcare
  6. 6. 6 http://www.hhs.gov/healthcare
  7. 7.  Benefits for Adults  Insurance options  Preventative Service Coverage  Lower Costs  No Cost screenings  Pregnancy benefits  Children Coverage  Coverage up to age 26  Preventative Service Coverage  Vaccinations  Emotional & Behavior wellness 7 http://www.hhs.gov/healthcare
  8. 8.  Services for Seniors  Medicare Preventative Services  Medicare Drug Discounts  $250 Rebate for Prescription Drugs  Strengthening Medicare  Holding Insurance Companies Accountable  Justify rate increases greater than 10%  Can not refuse coverage for pre-existing conditions 8 http://www.hhs.gov/healthcare
  9. 9.  2010: A new Patient's Bill of Rights goes into effect, protecting consumers from the worst abuses of the insurance industry. Cost-free preventive services begin for many Americans.  2011: People with Medicare can get key preventive services for free, and also receive a 50% discount on brand-name drugs in the Medicare “donut hole.” 9 http://www.hhs.gov/healthcare
  10. 10.  2012: Accountable Care Organizations and other programs help doctors and health care providers work together to deliver better care.  2013: Open enrollment in the Health Insurance Marketplace begins on October 1st.  2013: Open enrollment in the Health Insurance Marketplace closes on March 31st.  Purchase by December 14, 2013 to BEGIN COVERAGE JANUARY 1, 2014. 10 http://www.hhs.gov/healthcare
  11. 11.  2014: All Americans will have access to affordable health insurance options.  The Marketplace will allow individuals and small businesses to compare health plans on a level playing field.  Middle and low-income families will get tax credits that cover a significant portion of the cost of coverage.  Medicaid program will be expanded to cover more low- income Americans.  Millions of people who were previously uninsured will gain coverage, thanks to the Affordable Care Act. 11 http://www.hhs.gov/healthcare
  12. 12.  There is a fee for not signing up for 2014 insurance  2014 – The highest amount of  $95.00 per adult  $47.50 per child  1% of your income  2015 – The highest amount of  $325.00 per adult  $162.50 per child  2% of your income 12 Jen Christensen - www.cnn.com 10/1/2013
  13. 13.  Ask current doctors  Companies accepting in 2014  Plans they recommend for your needs  Some may not answer this one  Does not hurt to ask  Read coverage carefully  Preventative  Outpatient vs. Inpatient  Out-of-Network vs. In-Network  Deductibles – What you have to pay 13
  14. 14.  Flexible Savings Account  Tax free savings for prescription and copays  Use it by the end of year or lose the money  May (or may not) be used for over the counter meds  Dental and Vision will be separate  Some plans may have one free annual visit for these  Check pediatric and young adult coverage  Prescription Drug Terms  Generic vs. Name Brand  Deductible vs. Copay 14
  15. 15.  Terms – Shared costs with you and insurer  Coinsurance – Insurer splits costs with you  Copay – Payment at the time of service  Before Deductible / After Deductible  Additional Coverage  Chiropractic  Hospice  Additional Information  Am Best Rating – Report Card for Insurance Companies  This rating should not be older than 2 years or lower than a B+  NR = Not Rated… stay away from these! 15
  16. 16.  https://www.healthcare.gov  Select “Apply Now”  Select your state and “Apply Now”  Create a Market place account  Enter name and email address [mandatory]  Create a username and password [write down & save]  Create security questions and provide answers 16 http://www.hhs.gov/healthcare
  17. 17.  Go to email to receive confirmation of account  Login using user id and password  Begin the application process  Problems or Questions call the Customer Service Center at 1-800-318-2596  DO NOT sign up or pay for a policy you are unsure about! 17 http://www.hhs.gov/healthcare
  18. 18.  http://www.healthcare.com  A secondary site for insurance quotes  Go directly to company websites  Blue Cross Blue Shield - http://get.bcbsga.com  Subsidized health plan for students and grads  Kaiser Permanente – http://www.kp.kaiser.org  Cigna - http://www.cigna.com  Other – all companies have websites ready  Interactive subsidy calculator  http://kff.org/interactive/subsidy-calculator/ 18
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