01 October 2013

The Affordable Care Act and you

It's here at long last. Though the Patient Protection and Affordable Care Act has been the law of the land since March 23, 2010 today marks the day when most people will notice the sea change it ushered in. Despite the fact that one of our political parties has been having a tantrum about it since the presidential election of 2008, despite that same party's willingness to shut down the Federal Government and sabotage the economy rather acknowledge the fact that Barack Obama is the President and despite the fact that same party's been hijacked by it's own lunatic fringe, the health insurance marketplaces are open for business.

So what does that mean precisely? Well with the help of Fran Berkman at Mashable and the Kaiser Family Foundation, here's a breakdown.

Whether or not you agree with the country's new health care policy, you should understand how it works. Here are a few things you need to know to get started.

The law is scheduled to take effect fully on Jan. 1, 2014. You can begin shopping and signing up for plans through the online marketplace starting today but the earliest a plan will take effect is Jan. 1. The enrollment period for 2014 lasts until March 31.

For subsequent years, the enrollment period will be open from Oct. 15 until Dec. 7. With few exceptions, these are the only time periods during which you can register for plans through the online marketplace.

Technically, using the health insurance marketplaces is available to everyone lawfully living in the U.S. The online marketplace is targeted at those who do not get insurance through their employers, but earn too much to qualify for Medicaid. The new law actually expands eligibility for Medicaid, and Medicaid rules vary by state. Your state's health insurance marketplace website will help you figure out whether you qualify. Alternatively, even if you do receive insurance through your employer, you can still use your state's online marketplace — though you're unlikely to find a better deal.

The "personal mandate" to have insurance means you will be charged a fee if you're uninsured for more than three months in a calendar year. The penalty, which increases each year, starts at $95 in 2014 or 1% of your yearly income — whichever is higher. If you choose to pay the fee, you do so when filing your tax returns. You may be exempt from paying this fee if you meet one of several conditions (listed here).

Residents of most states can find their online marketplace at HealthCare.gov. For residents of 16 states and the District of Columbia, however, there are state-specific websites. A "Get State Information" drop-down menu sits toward the bottom of this page and will instruct you where to find information based on where you live. Again, the main HealthCare.gov website will direct you via links to anywhere you need to go to research and buy a health insurance plan.

Prepare most of your personal documents for reference, specifically financial records. Since the law varies depending on your income, you will most likely need your recent tax returns and pay stubs.

The plans are divided into four tiers based on cost and level of coverage: bronze, silver, gold and platinum. The government will subsidize your health care with a tax credit if your yearly income is less than four times the poverty level.

The health care-focused Kaiser Family Foundation created the calculator below to help you figure out whether you are eligible for subsidies.

Remember that everyone is protected equally under the new law, meaning you can't be charged more due to gender or medical history. Additionally, you cannot be denied coverage due to any pre-existing conditions and your insurer cannot drop your policy after you file a claim. Although plans vary in level of coverage, all plans must cover 10 "essential health benefits" — including ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services and more. While this part of the law took effect in 2010, remember that young people can stay on their parents' insurance plans until age 26.

For more information, the Kaiser Family Foundation has a number of resources on its website, or go straight to the source by visiting HealthCare.gov.

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