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STAY INFORMED! WHAT YOU NEED TO KNOW ABOUT HEALTH CARE REFORM May 2012
STAY
INFORMED
!
WHAT YOU NEED TO KNOW ABOUT
HEALTH CARE REFORM
May 2012
PROBLEM:Health
Insurance Costs Are TOO
High!
o Lowers the cost of individual & small business health insurance
o Improves the quality of health careo Makes health care more accessible
WHAT DOES THE AFFORDABLE CARE ACT (ACA) DO FOR YOU?
AM I REQUIRED TO HAVE HEALTH INSURANCE?o All individuals MUST be enrolled in a
health insurance plan by 2014 that meets basic minimum standards, as set by the governmento This can include Medicaid
o If you don’t have health insurance, you will have to pay a fee*
*Waivers are available under certain conditions, such as religious beliefs
2014$95/year
2016$695/year
DO YOU QUALIFY?o Lawfully present individuals must
buy health insurance (individual mandate)
o May buy health insurances in state exchanges or qualify for Medicaid
o May qualify for federal assistance if <400 Federal Poverty Level (FPL)o Individual: Annual income <$44,680o Family of Four: Annual income <$92,200
EXPANDS CAREBy 2014, all pre-existing Conditions, lifetime Coverage caps and annual Limits are banned
Dependent coverage is extended to age 2626
BENEFITS FOR WOMEN Ban on lifetime
coverage limits Allow adult
children up to age 26 to join or remain on a parent’s health plan
Phased-in ban on annual limits
Pre-existing ConditionInsurance Plan
Preventive services coverage without copay
$250 rebate for Medicarebeneficiaries in Part D
Phased-in ban on annual limits
Better coverage and lower cost on brand name prescription drugs for Medicare beneficiaries in Part D
Medicaid expansion
State insurance exchanges
Insurance market reforms, including no rating on gender
Premium and cost sharing credits for exchange plans
Employer shared responsibility penalties
2010 2011- 2013 2014
WHAT’S COVER
ED?Mammograms
Vis ion CarePregnancy
Annual Wel lness Vis i tsBreastfeeding Support
ColonoscopiesVaccinat ions
Newborn CareMental Health Services
Substance Abuse Services
Health Exchange = New Market to Buy Insurance!
HOW CAN I GET HEALTH INSURANCE?
NEED MORE INFORMATION?o www.IllinoisHealthMatters.orgo www.HealthCare.govo Asian and Pacific Islander American Health
Forum (http://www.apiahf.org/)o Kaiser Family Foundation
o Implementation Timeline: (http://healthreform.kff.org/timeline.aspx)
o Healthcare Hits Main Street Video http://www.youtube.com/watch?feature=player_embedded&v=3-Ilc5xK2_E
