Affordable Healthcare Act – Explained

The impact of the Affordable Care Act (ACA) to individuals and families:

The Affordable Care Act was passed into law on March 23, 2010. The provisions of the law are being rolled out over a number of years.

Right Now is a Great Time to Shop for a plan. Avoid tax penalties and take advantage of the new changes that are included in the Affordable Care Act. Some of the benefits are:

  • Covers Preventive Care at No Cost to You: There is no copayment for preventive care services.
  • Choice of Doctors: Choose the primary care doctor you want. The primary care doctor may or may not participate in all plans.
  • Emergency Services: You can seek emergency care at a hospital outside of your health plan’s network
  • Ends Pre-Existing Condition Exclusions for Children: Health plans can no longer limit, or deny benefits to children under 19 due to a pre-existing condition.
  • Young Adults under 26: If you are under 26, you may be eligible to be covered under your parent’s health plan.
  • Withdrawals of Insurance Coverage: your insurance can no longer be cancelled other than for non-payment of premium.
  • Ends Lifetime Limits on Coverage: There are no longer any Lifetime limits on most benefits.
  • Reviews Premium Increases: Insurance carriers must now publicly justify any large rate hikes.
  • Helps You Get the Most from Your Premium Dollars: Your premium dollars must be spent primarily on health care and not administrative costs.

Qualifying Life Events:

Unlike in the past, Open Enrollment deadlines now exist in order to enroll in an individual or family plan. However, there are also Qualifying Life Events that can make you eligible to enroll in a plan outside of the Open Enrollment period.

  • Loss of health care (essential minimal coverage)
  • Loss of job or employer-sponsored coverage
  • Gaining or becoming a dependent
  • Birth, adoption, or placement for adoption
  • Marriage
  • Divorce
  • Enrollment error
  • Contract violation
  • Permanent relocation
  • Immigration status change

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