The Affordable Care Act aims at improving care and lowering costs for every person whether healthy individuals or people with health conditions. It is offering creation of Health Insurance Marketplace to give consumers a choice of getting best fitted insurance option in a transparent and competitive way. It will also cut down on hassles of getting a health insurance. The provisions made in the Affordable Care Act for Healthy individuals and for People with Health Conditions are discussed below separately.
Healthy Individuals and the Affordable Care Act
Anyone can need a health insurance any time. Even someone is health; nobody knows when one will fall ill. Thus going for a health insurance is a prudent thing to do. The Affordable Care Act has expanded health insurance options and made it more accessible and more affordable. What the Affordable Care Act offers to healthy individuals is being discussed below.
- The Act prohibits insurance companies from denying coverage to any individual when he falls sick due to a mistake on coverage application.
- Parents can include their children under age 26 in their health plan if the plan allows for dependent coverage. Only in case of the child getting his own job based plan alongside his parent’s existing job-based plan, he will be excluded from his parent’s health plan.
- Job-based health plans and new individual plans cannot deny coverage to any child under 19 on basis of health conditions, including babies born with health problems.
- People earning less than the equivalent of about $88,000 for a family of four and having no job based affordable health coverage can ask for tax credits to get help in paying for insurance. This law will be enforced from 2014.
- From 2014 one can directly buy insurance from Health Insurance Marketplace if the employer doesn’t offer insurance. It gives the consumer power to choose the best fitted insurance for him in a transparent and competitive way from wide variety of insurance options.
Individuals with Health Conditions and the Affordable Care Act
People with health conditions have more dire need of health insurance. The Affordable Care Act has made their options wider and is offering more affordable health insurances. Provisions for them are discussed below.
- Any person with health condition who has been uninsured for at least six months may get health insurance through Pre-existing Condition Insurance Plan.
- The insured persons have tight to appeal decision of insurance company if he feels that he is denied the coverage for services he willed he was covered for.
- Insurance companies cannot drop any individual from coverage when he falls sick due to an error or mistake on coverage application.
- The Act prohibits insurance companies from denying coverage or charging more for any pre-existing condition including disability. It applies to all job-based and new individual plans from 2014.
- Individuals with income less than the equivalent of about $88,000 for a family of four today without any job based affordable health coverage may get tax credit to pay for health insurance from 2014.
- Individuals can avail services of Consumer Assistance Program if they are insured and have problems or queries regarding their plan.
- Any individual have right to information and appeal if he has been rejected for insurance or denied a claim.