What is Obamacare?

FamilyObamacare is the nickname for the Affordable Care Act, a piece of legislation that is revising our healthcare market. Last year, 7.1 million Americans signed up for health plans under the Affordable Care Act (Obamacare), and it is estimated that next year, in 2015, 13 million people will sign up under the Affordable Care Act (Obamacare).

What parts of The Affordable Healthcare Act directly affect me?

Two of the primary requirements of the Affordable Care Act that directly affect our clients are:
#1 All Americans are required to have health care coverage (or will be fined!)
#2 All Healthcare plans must include certain benefits

#1 To ensure that all Americans are able to have health care coverage, the Affordable Healthcare Act legislation dictates that:

  • No one can be turned down for coverage due to any preexisting conditions. There are no pre-existing condition exclusions.
  • All people who have difficulties paying for coverage, based on their income, will be eligible for a subsidy. With a subsidy, health insurance is affordable to them.
  • If they are under 133% of the poverty level, they will go on Medicaid, unless their state refuses to expand Medicaid.
  • There will be an enforced penalty if you don’t have coverage.

#2 To ensure that all Americans have quality healthcare coverage, the Affordable Healthcare Act legislation has certain requirements that all plans must meet. These are called the Essential Health Benefits. One of the most important benefits for our customers is:

  • Everyone is entitled to a free annual physical checkup. This is considered a preventative visit and is completely free.

Other Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

  • Insurance policies must cover these benefits in order to be certified and offered in the Health Insurance Marketplace. States expanding their Medicaid programs must provide these benefits to people newly eligible for Medicaid.

Common Questions Regarding Obamacare:

Can I be on Obamacare and keep my favorite doctors?

Obamacare, is not a type of insurance. Obamacare is referring to the Affordable Care Act legislation.

Your doctor accepts certain insurance carriers. When you choose your insurance plan, you can choose an insurance that your doctor accepts. Since the majority of insurance carriers have plans through the Healthcare Marketplace,  you should be able to choose an insurance plan your doctor accepts.

I’ve heard a lot of doctors don’t accept Obamacare? Is that true?

The only information your doctor receives is your insurance card which outlines the details of your network plan and your insurance carrier. If your doctor accepts the insurance carrier and your network plan, then your doctor will accept your insurance. It does not matter whether or not you are receiving a subsidy.

Why can I only enroll during Open Enrollment?

There are only three months out of the year that people can sign up for the Affordable Health Care Act (Obamacare). The dates for Open Enrollment are between November 15 and February 15 of every year. If people could sign up for healthcare year round, then people would only sign up when they needed medical services. Because of this, there is only a three month window to enroll in Obamacare.

Is there really going to be a penalty for not having insurance?

Yes. There will be a penalty. It will be either 2% of your yearly household income or it will be $325 per person for the year.