Affordable Care Act

In 2010, the Affordable Care Act was signed into law by President Barack Obama as a comprehensive healthcare reform. The main objective of the new program was to extend health-insurance coverage to millions of uninsured Americans through a new list of health-related provisions. The Affordable Care Act also expanded eligibility for Medicaid, preventing insurance companies from charging more or denying coverage based on pre-existing conditions. It also created a health insurance exchange and allowed children to remain under their parents’ insurance plan until 26.

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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For more information on the Affordable Care Act or to get a free quote, give us a call at 713-900-1901.