What kind of coverage will the plans sold through the marketplaces include?
The Affordable Care Act (ACA) requires that all health insurance plans sold in the marketplaces beginning Jan. 1, 2014 cover ten essential benefits:
Ambulatory patient services – including outpatient and doctor visits
Maternity and newborn care
Mental health and substance use disorder services, including behavioral health treatment
Rehabilitative and habilitative services and devices
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care
What are they referring to when they talk about the metal tiers?
In addition to addressing what will be covered, the Affordable Care Act also broadly outlined the level of benefits – how health care costs will be split between health plans and consumers.
General percentage by level paid by consumer
(through deductibles, copays and coinsurance)
Bronze Level – 40%
Silver Level – 30%
Gold Level – 20%
Platinum Level – 10%
What are some of the advantages of the Affordable Care Act?
Guaranteed Issue- Anyone who applies is accepted
Guaranteed Renewal – You get to keep your plan as long as you pay the premiums
No preexisting conditions are considered
Woman and Men don’t have different rates
No more caps on Essential Health benefits
Dependent coverage until age 26
2014 Federal Income rates Released
Federal Poverty Guidelines 2014
Health Reform Explained Video: “Health Reform Hits Main Street” Kaiser Family Foundation