The Affordable Care Act and You

Open Enrollment Starts October 1

There's been a lot of talk about the Affordable Care Act (ACA) and what it means for our lives. Just this morning there was talk on one of the networks that the law remained unclear to many, and understandably so, as we haven't yet seen its full effect. But you don't have to be confused! Here I want to briefly outline what the new law could mean for you and your family. The information here is from the State of Michigan and the US Government, so let's look deeper and get beyond the media hype. Understanding how insurance works is never easy, but you can be better prepared by doing a little reading before October 1.

Is the government requiring all Americans to be covered by health insurance?

Yes, including children, beginning January 1, 2014. 

All Americans must have health insurance that meet the 'minimum essential coverage' outlined here.

If you fail to enroll in a plan that meets the requirements you will pay a fine, described here, plus you will be responsible for your own medical costs. 

Where do I look for my insurance options?

The ACA mandated that each state set up a healthcare 'marketplace,' the government word to describe an online location where citizens can research their options and compare plans. Think of it as shopping for insurance. The State of Michigan has opted to use the federal government's marketplace, which can be found at Healthcare.gov. This is where you will go online to look for insurance starting October 1.

Who is eligible to participate?

 

Starting October 1, you will be able to go through the initial process (answering some questions) to determine if you qualify for insurance from the marketplace or through another program (i.e. Medicaid). If you have coverage through your employer and you're happy with it, you can keep it, just be aware of the minimum essential coverage guidelines mentioned above. Maybe you have insurance at work but it's very expensive - the marketplace could provide you savings each month. 

Many Americans do not have employer benefits such as insurance, and for those in this situation the marketplace is ideal. Maybe you make too much to qualify for medicaid and yet you've found monthly premiums through an individual plan to be too expensive at the desired coverage level. The marketplace allows you to gain the buying power and lower rates of a group plan.

How does the ACA affect Medicaid, Medicare, and the Child Health Insurance Program (CHIP)?

Excellent question! If you are currently covered by Medicare, your coverage meets federal requirements - your coverage continues uninterrupted. Medicaid and CHIP also continue as usual, and in fact Medicaid eligibility has been expanded in many states, including Michigan. Read about Medicaid eligibility here and here, your eligibility is based on the size of your household and family income.

How long do I have to decide to use insurance through the marketplace?

Open Enrollment, the period during which you can sign up, starts October 1, 2013 and continues until March 31, 2014. You must apply for a plan through the marketplace during this period to be covered in 2014 by a marketplace plan. Again, if you have coverage you like or are on Medicare you don't have to sign up for a new plan. If you want coverage to start on or close to January 1, 2014 you should apply during early December or before.  

What can I do to prepare if I anticipate enrolling in a marketplace plan?

Check out this application checklist and think more about exactly what you'd like from your insurance plan and what you can afford to pay each month. Both of these aspects of the plan will be outline when you browse your options starting October 1. Having your Social Security Number, income information (found on your W-2s from your employer), and any current policy information will make the application process easier. Review the checklist above for more information.

For even more information check out the embedded links in this post or head over to Healthcare.gov. The site has many more frequently asked questions that will help you navigate your options. Remember that there will not be concrete rates available until October 1 at which point you will be able to compare coverage, out-of-pocket  costs, and monthly premiums. 

And finally, if you don't have home access to the internet, stop by any branch of the GDL to complete the process online.