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Interesting Facts – Health Care Reform

There are 5.3 Million uninsured people in California

Three reasons why people don’t have medical insurance (1) they have a  pre-existing condition (2) not offered by employer (3) unaffordable

January 1, 2014 health insurance will be guarantee issue – no health questions, no pre-existing conditions

Three options for coverage in 2014 (1) employer plan (2) buy insurance through the Marketplace if you are eligible for subsidy/tax credit or buy insurance through the traditional market (3) go uninsured and pay a penalty

Rates based on income, where you live, age & other factors

Covered California open enrollment begins October 1st for a January 1, 2014 effective date

There will also be a Catastrophic Plan for individuals under 30 who don’t qualify for tax credits

Check your 2013 tax return – are you eligible for a subsidy? 

Subsidies for Individuals based on income and not having employer health insurance or its not affordable (over 9.5% of your income)

Everyone purchasing an individual plan will have access to expanded benefits, lower deductibles and lower out of pocket maximums

*All new plans must include “essential health benefits”:

            1. Ambulatory patient services

            2. Emergency services

            3. Hospitalization

            4. Maternity and newborn care

            5. Mental health & substance use disorder services,

                  including behavioral health treatment

            6. Prescription drugs

            7. Rehabilitative and habilitative services and devices

            8. Laboratory services

            9. Preventive and wellness services and chronic disease management

            10. Pediatric services, including oral and vision care

                        *Healthcare.gov: Essential health benefits

 

 
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