Reducing Costs Through Tax Credits and Cost-Sharing Reductions
Created to reduce the cost people would have to pay for health insurance coverage, the Affordable Care Act included cost-saving measures such as premium tax credits and cost-sharing reductions. If qualified for them, the premium tax credits worked to lower the monthly health insurance bill. Cost-sharing reductions, on the other hand, were aimed at lowering out-of-pocket costs for copays, deductibles, and coinsurance. It also helped to lower the out-of-pocket maximum that had to be paid annually for health expenses.
In order for a health insurance plan to be sold on the Health Insurance Marketplace it has to offer the following essential health benefits:
- Pediatric services
- Mental health and substance use disorder services
- Hospitalizations
- Family planning
- Breastfeeding
- Ambulatory patient services
- Rehabilitative and habilitative services
- Preventative and wellness services and chronic disease management
- Laboratory services
- Pregnancy, maternity, and newborn care
- Prescription medications
The Affordable Care Act also requires that insurance plans cover preventative services for policyholders at no additional cost. These services can include health screenings, checkups, immunizations, and patient counseling.
Qualifying for Coverage Under the Affordable Care Act
Unlike many other insurance plans currently available, receiving benefits through the health insurance marketplace is quite easy. To qualify you must live in the United States, be a U.S. citizen or lawfully present, and you cannot be incarcerated. It is also important to note that you will not be eligible to use the marketplace for dental or health plans if you have Medicare coverage already. While it is not a requirement for the Affordable Care Act, to qualify for subsidies, your income must not be more than 400 percent of the federal poverty level.
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