Health Insurance Know Your Options. Affordable Care Act Basics. What is the Affordable Care Act?
What is the Affordable Care Act?
The Affordable Care Act increases access to health coverage for consumers through:
The Affordable Care Act adds new requirements for health insurance companies.
Coverage Options (continued)
60% 70% 80% 90%
Lower monthly premium Higher monthly premium
Higher out-of-pocket costs Lower out-of-pocket costs
** Health plan categories do not reflect the quality or amount of care the plans provide.
When consumers get health coverage through the Marketplace, depending on income and family size, they may be able to save money.
Types of cost savings include:
Premium Tax Credits
Some consumers may be able to lower the cost of their monthly premiums through advanced premium tax credits.
Advanced Premium Tax Credits
Cost-sharing reductions lower howmuch consumers pay for deductibles, copayments, and coinsurance. To be eligible for cost-sharing reductions, a consumer must:
There are two ways to access the Marketplace:
For 2014, the SHOP Marketplace is open to employers with 50 or fewer full-time-equivalent employees (FTEs).
Enrollment and Coverage Dates
Exemptions through the Marketplace
How to Get Insurance
Health insurance inside the marketplace – Consumers were able to enroll in health coverage through the marketplace until March 31, 2014.
Health insurance outside the marketplace – Consumers can obtain health coverage through a health insurance company that sells insurance outside of the marketplace.
Job-based insurance – Consumers who are currently employed may be able to purchase health coverage through their employer, called employer-sponsored or job-based.
Insurance under a parent’s policy – Younger adults ( up to 26 years old) are eligible to enroll in health coverage under their parents health insurance plans if those plans cover dependents.
Additional Health Coverage Options
Medicaid – a joint federal and state administered health insurance program for low income families and children, pregnant women, the elderly, people with disabilities, and in some states, other adults.
Medicare – Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
Children’s Health Insurance Program (CHIP) - a program jointly funded by state and federal government that provides health coverage to low income children and, in some states, pregnant women, and families who earn too much to qualify for Medicaid, but they cannot afford private health insurance.
TRICARE – is the Department of Defense (DoD) healthcare program available to eligible members and their families of the seven uniform services: the US Army, US Navy, US Air Force, US Marine Corps, US Coast Guard, commissioned Corps of the US Public health service, and the National Oceanic and Atmospheric Administration.
Veteran’s Affairs (VA) Health Benefits– the Department of Veterans Affairs (VA) administers a variety of benefits and services that provide financial and other forms of assistance to service members, veterans, their dependents and survivors. As part of these benefits and services, the VA provides health coverage for eligible veterans who served in the US military.