Affordable Care Act

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Affordable Care Act

The Affordable Care Act (otherwise known as “Obamacare”) passed in 2010 and revolutionized the health insurance market.  Starting in 2014 plans were required to be guaranteed issue and offer a comprehensive package of essential health benefits.  This law also created a new marketplace to obtain coverage at  Plans now can be purchased On-Marketplace with premium assistance in the form of subsidy tax credits based on individual / family projected adjusted gross income, or purchase Off-Marketplace directly from the insurance carrier.  Our Licensed Agents will help you to determine if you or your family qualify for the subsidy premium tax credits. Today, there are hundreds of health policies offered in the greater Jacksonville Florida area. Each with different premiums, provider networks and benefits. When trying to decipher the “best option” via the internet remember price is only one of the three key components. Our agents will verify the provider networks for your doctors and hospitals of choice.  Additionally, we help you get matched to your risk tolerance in relation to plan benefits copays, coinsurance, deductibles and medication formularies. Having the right coverage when you family in needs it the most is our upmost concern. It is much easier and secure to let us do the free research for YOUR 3Rs *** Right Doctors, Right Coverage, Right Price!

If you did not enroll during the annual Open Enrollment Period, you may still qualify through a triggering event (like Loss of Creditable Coverage) for a temporary Special Enrollment Period, which gives you 60 days to apply.  These life events may be the following: 1) Gain a Dependent 2) Gain Citizenship Status 3) Loss of Group Coverage 4) Marriage or Divorce 5) loss of Medicaid or Medicare.  These are the most common Triggers but there are other opening Events so contact us for your eligibility questions.

CAUTION – Temporary and Limited Benefit Plans are also offered in the market but do not qualify as Essential Creditable Coverage deemed by the Affordable Care Act and typically do not cover pre-existing conditions, have underwriting requirements, and do not offer comprehensive benefits.  We can help you determine if these plans meet your needs.

Facts about Health Care Reform

Patient Protection and Affordable Care Act or PPACA is the official name for Health Care Reform. It was signed into law on March 23rd, 2010 and the Supreme Court upheld it on June 28th, 2012. Then again upheld the decision for subsidies on June 25, 2015.

The goal of Health Insurance Reform is to provide accessible, quality health insurance for United States residents, at an affordable price. The PPACA achieves this goal through taxes, subsidies, insurance exchanges, consumer protections, regulations and other reforms. Florida Health insurance is provided through the National Exchange, but your agent can help you make sure you pick the plan that bests suits your needs at no additional costs.

An open enrollment period is provided every year for those without coverage. Once this period expired, those needing health insurance can obtain short-term health insurance until the next open enrollment period, unless they are eligible for a special enrollment period.

About one out of every six Americans selecting a plan from the health insurance marketplace was able to get coverage for less than $100 per month. More than 85% of those using the marketplace plans received financial assistance in 2019. A few other facts about ACA are:

  • Young adults may stay on their parents’ healthcare plan until they are 26 years of age.
  • Insurance companies cannot deny coverage or charge more due to your health status.
  • Insurance companies cannot drop you when you become ill or if you make an honest mistake on your application.
  • Provides tax benefits for small businesses.
  • Requires larger businesses with 50+ number of employees, to provide insurance for employees.

The Affordable Care Act has changed many things about the way healthcare works in the United States. These are just a few of the major changes and facts about ACA.

Benefits of the Affordable Care Act

Whether you need health coverage for your family or just for yourself, Health Insurance Reform provides many new benefits, rights, and protections. With the new Health Insurance Marketplaces or Exchanges, you can easily shop for health plans, which will provide the essential coverage you need to gain all the benefits, rights and protections of the Affordable Healthcare Act.

Cost assistance is the most important benefits and helps provide families, individuals and small businesses with affordable health coverage. ACA allows for those fitting the income requirements (between 100% to 400% of the federal poverty level) to deduct a portion (up to 100%) of the cost of health coverage. Instead of paying out of pocket and taking the dedication on your annual taxes, the deduction is applied to your monthly premium.

Along with making health coverage more affordable, the Affordable Care Act (ACA) helped to expand Medicaid eligibility in 26 states. This expansion has allowed many Americans to take advantage of Medicaid even if they didn’t qualify in the past.

Other benefits associated with Health Care Reform include:

  • No lifetime limited or annual limited on healthcare.
  • Guaranteed issue, even with pre-existing conditions.
  • A faster appeal process for insurance company decisions.
  • Easier summaries to help you understand the coverage and benefits provided with your plan.
  • Better women’s health services with more free preventative screenings and treatments.
  • Better care for seniors.
  • Many preventative services provided at no-out-of-pocket cost
  • All non-grandfathered plans must include coverage for hospitalization, maternity, newborn care, emergency care and prescription drugs with no out-of-pocket limit.
  • And Many More!

The Affordable Care Act has made it easy to find and obtain affordable healthcare plans with many new benefits.

Has ACA Worked?

More than 11 million people had enrolled in a health plan by the end of 2019. This number included 2 million new enrollees and about 8.5 million auto-renewals and renewals.

Along with the numbers from 2019, it’s estimated that more than 11.5 million were enrolled in federal and state marketplaces by the end of open enrollment in 2019. More than 10.5 million were covered through CHIP and Medicaid, while over 5.5 million young adults were able to remain on their parents’ plan.

These numbers don’t include the many Americans covered through employer plans with expanded coverage under the Affordable Care Act. It also doesn’t include anybody using a private plan found outside the marketplace.

A report created by the Commonwealth Fund is the best proof of ACA working, however. This report was issued in January of 2019 and showed a lower number of uninsured Americans with an increase in access to care and affordability. The number of uninsured Americans was the lowest it has been since 2001, according to the report.

Overall, the Affordable Care Act is not only working but also benefiting many Americans, especially low-to-middle income and young adults. If you have further questions about how ACA coverage works or how to ensure you have qualifying coverage, contact your local Jacksonville health insurance agent to learn more about affordable health insurance and get a custom quote.

You are covered