Regardless of the mindless mindset of the GOP to shut down our government,
Obamacare will finally become a reality in people's lives next week.
It is time to truly understand what it is and how to make
it's many facets work for the BEST EFFECT on our own personal lives.
If someone is lazy and puts it off until after March 31, 2014,
they will have only themselves to blame if things don't go the way they hope/expect.
Here is an very good article that can be a gateway into understanding
the "whats-in -it-for-me" and "what-should-I-do"...
NY Times
ARA SIEGEL BERNARD
9/27/13
A Guide to the New Exchanges for Health Insurance
Quote:
Given all of the rhetoric about the Obama administration’s health care law,
it’s not surprising that many consumers are confused about how
the new insurance exchanges will actually work.
Some states that oppose the law have gone as far as intentionally
limiting the information that trickles out to its residents.
But after much anticipation, the curtain will finally rise on the exchanges next week,
providing millions of consumers with an online marketplace to compare
health insurance plans and then buy the coverage on the spot.
The exchanges are likely to be most attractive to people who qualify for subsidized coverage.
Individuals with low and moderate incomes may be eligible for a tax credit,
which can be used right away, like a gift card, to reduce their monthly premiums.
People with pre-existing conditions will no longer be denied coverage
or charged more (this applies to most plans outside the exchanges, too).
And all of the plans on the exchanges will be required to cover
a list of essential services, from maternity care to mental health care.
Q. Where can I apply or get more information on the exchanges?
A. To avoid fraud artists, enter through the front door: Healthcare.gov.
From there, you can find links to the exchange offered in your state.
There may be technical glitches as the program gets started,
so alternatively, you can call 1-800-318-2596.
Q. What sort of coverage will be offered?
A. All plans will have to provide the same set of essential benefits,
including prescriptions, preventive care, doctor visits, emergency services and hospitalization
(this also applies to most individual and small-employer group plans sold outside of the exchanges).
But plans can offer additional benefits, or different numbers of services
like physical therapy, so you’ll need to do a side-by-side comparison to see what fits your needs
— or at least the needs you can anticipate.
Q. Are the plans sold on the exchange more comprehensive than plans outside?
A. There are four plan levels, each named for a precious metal.
They all generally offer the same essential benefits, but their cost structures vary.
The lower the premium, the higher the out-of-pocket costs.
The bronze level plan, for instance, has the lowest premiums,
but will require consumers to shoulder more costs out of pocket.
They generally cover 60 percent of a typical population’s out-of-pocket costs,
and include deductibles, co-payments and coinsurance.
The silver plans cover 70 percent; gold, 80 percent;
while platinum covers 90 percent (and therefore carries the highest premiums).
Q. Will I be eligible for a premium tax credit (subsidized coverage)?
A. People with income between 100 percent of the poverty line
(or about $23,550 for a family of four) and 400 percent of poverty ($94,200 for a family of four)
are eligible for a tax credit to defray premium costs.
(All income eligibility is based on your modified adjusted gross income;
the online version of this column links to a guide explaining how that is calculated).
Q. Can I get help with my out-of-pocket expenses, like deductibles?
A. People with incomes between 100 percent of the federal poverty line
($23,550 for a family of four) and 250 percent ($58,875 for a family of four)
are also eligible for cost-sharing reductions, which means you’ll pay less
for items including deductibles and co-payments, and you’ll have lower out-of-pocket maximums.
<SNIP>
etc.
etc.
etc.
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