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The Affordable Care Act-Obamacare-National Health plan

What is it? When does it start? How do I apply for it? What plan options are available? How much will it cost?

These are just a few of the questions that we all may be asking ourselves between now and January 2014.

What is it?

Some of the other names it is known by are: Obamacare, National Health Plan and some may want to call it Socialized Healthcare. Whichever name we call it, the plan is on its way and here to stay.

The primary goal of the plan is to help millions of Americans access to health insurance coverage. To achieve that goal, the plan provides new coverage options, gives consumers the tools they need to make informed choices about their health care coverage, and puts in place strong consumer protections.

When does it start?

Starting in January 2014 individuals must obtain health insurance coverage or pay a penalty (some exemptions apply)

How do I apply for it?

There will be options on where you can apply for coverage and how. That may be slightly different depending on which State you reside in. The plans will be sold through a system that is called “Marketplace” or “Public Exchanges”. They will have State-based Marketplaces, State Partnership Marketplaces and Federally-facilitated Marketplaces.

Within the Marketplaces they will have four ways to apply for a new plan. There will be Navigators, Non-Navigators assistance personnel, Certified application counselors, Agents and Brokers. You will choose the method of how you want to apply and learn about the new plans.

What plan options are available?

The plan options will be identified by one of four metallic levels:

Bronze             =          60% Actuarial Value

Silver               =          70% Actuarial Value

Gold                =          80% Actuarial Value

Platinum          =          90% Actuarial Value

The plans will offer 10 Essential health benefits (EHB) that are required by the federal government.

-       Ambulatory patient  services

-       Emergency services

-       Hospitalization

-       Maternity and newborn care

-       Mental health and substance use disorder services, including behavioral health treatment

-       Prescription drugs

-       Rehabilitative and habilitative  services and devices

-       Laboratory services

-       Preventive and wellness services and chronic disease management

-       Pediatric services, including dental and vision care

Plans that cover benefits designated as essential health benefits, including self-funded plans, must cover these benefits with no annual limits or lifetime maximums.

How much will it cost?

The cost of the plan will be on a sliding scale based on an individual or families annual income. A premium subsidy (aka Premium Tax Credit) will be applied as a discount to the premium according to a formula as it relates to the Federal Poverty Level.

Individuals that are at or below 139% of the Federal Poverty Level will be eligible to receive Medicaid without premiums, while others may receive a Premium Tax Credit.  Anyone earning above 400% of federal Poverty Level will not receive federal assistance, and will be responsible for the entire premium cost.

The above information is only a brief outline of how complex the new National Health Plan will be. If you have any questions regarding your personal situation and need help understanding, navigating, or applying for a plan, please give us a call at the Insurance Hotline: 888-533-9019 or email us at: info@telalife.com


The Life Insurance Hotline
Bo Dillon, Certified Federal Facilitator

National Producer No. 1921787
Telalife.com  info@telalife.com