find your way around the new health care law (aca/obamacare)
Post on 10-May-2015
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Find Your Way Around The Health Care Law
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Agenda People with health insurance People who are uninsured or buy their own coverage People with Medicare
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People with Health Insurance
Adds More Consumer Protections
• Insurance companies can’t drop coverage if you get sick (Now)
• Insurance companies must justify increases to premiums and spend more on health care over administrative costs (Now)
• No one can be denied coverage for a pre-existing condition (2014)
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Eliminates Lifetime And Annual Coverage Limits
• Insurance companies can’t place lifetime limits on your coverage (Now)
• Insurance companies can’t place annual limits onyour coverage (2014)
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Mammograms Immunizations Screening for
cancer or diabetes
Requires Coverage For More Preventive Services
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People Who Are Uninsured Or Buy Their Own Coverage
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Makes It Easier to Buy Health Insurance
Offers Health Insurance Plans
by 2014
The Health Insurance Marketplace
1. Doctor visits2. Emergency Services3. Hospital care4. Maternity and newborn care5. Mental health and substance use disorder services, including
behavioral health treatment6. Prescription drugs7. Rehabilitative services and habilitative services and devices8. Laboratory services9. Preventive and wellness services, and chronic disease management10.Pediatric services, including oral and vision care
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Core Set Of Benefits
Several Levels Of Coverage
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Based on average cost of an individual under the plan. Figures may not be the same for every enrolled person.
• Starting 2014
• For health insurance purchased through the Marketplace
• Must meet income limits to be eligible
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Provides Help Paying For Insurance
Extends Coverage To Young Adults
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Adult children can stay on your family policy until age 26 even if they:
• No longer live with you• Are married• Are no longer in school
Options For States To Expand Medicaid• Your state has the option to expand coverage to more people
• Starts in 2014
• Must meet income limits to be eligible
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People Who Have Medicare
• Protects guaranteed Medicare benefits
• Improves Medicare benefits
• Lowers out-of-pocket costs for prescription drugs
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For People With Medicare
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Lowers Out-Of-Pocket Drug Costs
2020: Coverage gap will disappear
Part D cost sharing will
remain
2013: 52.5% discount on brand name
drugs
21% discount on generics
Medicare Drug Coverage
52.5% discount for Brand
Name and 21% for Generic
Initial Benefit Catastrophic Benefit
You pay: Deductible and 25% of drug costs
You pay: 5% of drug costs
Doughnut Hole
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Medicare Covers More Preventive Services
• Expands coverage for preventive care
• No copayments or deductibles for Medicare-approved preventive care
Call Medicare at 1-800-633-4227www.medicare.gov
• Increases consumer protections
• Makes it easier to find health insurance
• Improves Medicare-covered benefits
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Key Points To Remember:
The Health Care Law
www.HealthLawAnswers.orgwww.MiLeydeSalud.org
Medicarewww.medicare.gov 1-800-633-4227
www.healthcare.gov 1-800-318-2596
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For More Information
Questions & Answers
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