Your Guide to Understanding Obamacare Insurance Plans

Introduction to Obamacare insurance plans

The Obama Administration was successful in passing the Affordable Care Act in 2010. (ACA). This massive piece of legislation is made up of two independent bills: the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.

Both attempted to achieve two broad goals: increasing the number of American citizens with health insurance coverage and lowering healthcare-related expenses for both customers and the federal government.

This article goes through the ACA’s finer elements, including the following:

Provisions of various health plans accessible via the ACA
The design of the online marketplace (known as the ACA Healthcare Exchange) where individuals and small businesses may shop for insurance.
Important factors to consider while shopping for uninsured health insurance
Application instructions for health insurance
Financial consequences for people who do not acquire coverage are explained.
Information about ‘coverage gaps’ in state-to-state health insurance plans.

The Obamacare insurance plans require health insurance companies to provide the following benefits.

Coverage for young adults:

All men and women under the age of 26 are eligible for health insurance through their parents’ individual or employer-sponsored coverage plans. This law applies to residents of all states, regardless of whether the kid is married, enrolled in a higher-learning institution, qualified for employer-based insurance, or otherwise able to receive coverage in addition to their parents’ policies.

Medicaid Expansion:

One of the Obamacare insurance plans particular goals is to expand Medicaid and the Children’s Health Insurance Program (CHIP) to provide coverage for millions of uninsured, low-income American families.

The initial objective of the ACA was to expand state-sponsored Medicaid programs to cover anybody under the age of 65 who income at or below 138% of the Federal Poverty Level (FPL).

For the first time, low-income adults without children were to be eligible for Medicaid. Low-income men and women who are eligible for Medicaid, like other uninsured people, can use the ACA Healthcare Exchange to compare different coverage alternatives.

Subsidized Coverage:

Because the Obamacare insurance plans’ compulsory health insurance may force individuals and families to incur additional expenditures that are beyond their means, the federal government is subsidizing people’s health coverage if their yearly income falls below a specific threshold.

This subsidy is available to consumers who earn less than 400% of the FPL (approximately $48,000 per year for individuals and $98,000 for a four-member family). To assist web users in determining the amount to which they are entitled, eHealthInsurance provides an online subsidy calculator. For exact statistics, please consult the subsidy data table below.

Consumer Protection:

For many years, policyholders and health insurance companies have battled over health conditions that cause providers to terminate coverage to beneficiaries.

Pre-existing conditions, such as a lifelong disability or chronic sickness, cannot be used to deny coverage. In reality, insurance fraud is the sole reason a person may be refused coverage. Furthermore, providers cannot charge greater premiums to women or those with chronic health problems.
Plans must provide free preventative care, and insurance companies cannot place restrictions on ‘Essential Health Benefits,’ such as cancer screenings and preventive treatments.
Group health insurance plans must be implemented for all employees within 90 days of the person being eligible for this coverage.

Essential Benefits:

The following benefits are considered essential under the ACA and must be provided in all individual and group coverage plans:

Services for rehabilitation and rehabilitation (including certain devices)
Ambulatory patient care
Services for the disabled
Hospitalization
Services for children
Maternity and infant care
Services for mental health and drug abuse disorders (including behavioral health treatment)
Prescription medications
Services for laboratories
Prevention and treatment of chronic diseases

A Word About Grandfathered Plans:

Although the ACA is intended to regulate all health insurance plans in the United States (regardless of structure or provider), one major exemption to the federal rule is grandfathered insurance policies.

Coverage Application

As previously indicated, the open enrollment period for those seeking health insurance in 2018 concluded on December 15, 2017. Individual coverage seekers can get plans when the next open enrollment period begins in the autumn.