Affordable Care Act
We’ve all heard of the Affordable Care Act or “Obama Care” in some way or another. The main question going through everyone’s head is, “What on earth is it and how does it affect me?” In this section we will give you a brief explanation of what it is and how it affects you. We will also give you some helpful links to help get you started if you haven’t already.
What is the ACA?
The Affordable Care Act isn’t a health insurance despite popular belief. It’s actually two separate federal statutes, the Patient Protection and Affordable Care Act as well as the Health Care and Education Reconciliation Act of 2010. Together they make up the Healthcare reform law, “The Affordable Care Act” also known as “Obamacare.” President Barack Obama signed this United States Federal statute into law on March 23, 2010. These statues work together to make health care more affordable and more easily accessible to all Americans. It is meant to expand health care coverage to more people including many previously uninsured Americans, lower health care costs and make insurance companies more accountable for their spending. Not only did it provide many people with more insurance choices, it also expanded Medicaid coverage to millions of low-income Americans. You can shop or sign up for plans through the “Health Insurance Marketplace” or through a Healthcare Exchange. Exchange plans are insurance plans that were made specifically for the ACA and come from a wide variety of carriers. These plans will be state specific and tailored to fit each states requirements.
How does it affect me?
The Affordable Care Act or “ACA” made more health insurance options available to Americans but it also made health insurance coverage mandatory for all Americans as well. The ACA gave people a grace period to get comfortable with the requirement but made coverage mandatory in 2014. For those who did not acquire coverage, a fine or individual shared responsibility payment was applied. The fine or penalty is paid or deducted from your federal tax return at the end of the year based on your income.
(”If you have coverage for part of the year, the fee is 1/12 of the annual amount for each month you (or your tax dependents) don’t have coverage. If you’re uncovered only 1 or 2 months, you don’t have to pay the fee at all.”) -https://www.healthcare.gov/fees/fee-for-not-being-covered/
Is there anything I should be aware of?
There are many choices out there and it would be very difficult to outline them all. What we can advise you of is to choose your plan wisely. Very often we see families who select a health plan that has the lowest monthly premium and end up with a $6000.00 annual deductible. If you’re unfamiliar with a deductible, to put it simply, you will be responsible for paying the first $6000.00 in medical care before your insurance actually pays. Do you really get $6000.00 worth of health care per year? The only visit that is usually does not apply to it is preventive care) Check the Insurance Glossary for information on how deductibles work.) When you apply for insurance through the Marketplace, it is based on your annual income and family size. You may actually qualify for Nevada Medicaid or just a Subsidy. That’s a credit given towards your taxes at the end of the year based on your anticipated annual income when applying for insurance. This amount will change based on your final reported income for the year so be cautious of this number. Keep in mind that there are changes being made every day regarding the ACA and insurance plans. The “Exchange” plans are different that their commercial counterpart. We may take one regular commercial insurance but not the Exchange version of that insurance. It is always changing day to day and we do not always know when an insurance plan has come out with their own “Exchange” plan. Give our office a call to see if we accept your plan or a plan you are interested in. We will update our list of Exchange plans that we do accept as we learn of them. Most importantly, do your research! The better you understand your health insurance, the wiser you are about what you actually have to pay.
We do not accept:
Anthem BC/BS Pathway
We do accept:
HPN HMO Exchange only
Prominence HMO Exchange and regular plan
Aetna Exchange- pending but we do take regular Aetna
Silver State Exchange Network (select plans to come)
Helpful links to find and search plans:
- Health Insurance Market Place at: https://healthcare.gov/
- Health Exchange information at: https://www.healthinsurance.org/nevada-state-health-insurance-exchange/
- Nevada Health Link at: https://www.nevadahealthlink.com/
Learn more about the Affordable Care Act and how it affects you: