Many people will likely see their rates go up. But the good news is that the reform means thousands more Louisianians will now have health coverage.
Insurance companies are now accepting all customers, no matter their health condition. It costs more to cover people with pre-existing conditions. That's why rates will go up for just about everyone.
Plus, the new law says all new policies must include a minimum amount of coverage, called essential health benefits. That means we have added to all plans such things as: ER services, maternity care, mental health, lab services, pediatric care and pediatric vision services. Most plans saw this additional coverage in 2014. More benefits add to the cost of coverage.
Almost everyone must have health insurance. If they don't, they will be penalized on their federal income tax return. People who believe they can't afford insurance can go to healthcare.gov to request an exemption. For more information about penalties and exemptions, go to www.healthcare.gov.
In 2015 it's 2% of income or $325 per person. In 2016 and later years it's 2.5% of income or $695 per person. This will increase if you have minor children and do not buy insurance for them. It's important to remember that someone who pays the penalty have any health insurance coverage and will still be responsible for 100% of the cost of their medical care.
For 2015, you may begin enrolling Nov. 15. The marketplace will be open until Feb. 15, 2015. There are four easy ways to get coverage.
Healthcare reform will be funded in part by cuts in some programs and by taxes and fees on insurance companies, drug manufacturers, individuals, businesses, certain medical devices and equipment, and certain services.
Yes. When you purchase coverage, you will not be denied coverage because you have a pre-existing condition. Insurance companies cannot exclude your pre-existing condition from what it covers in your plan.
No. If you are on Medicaid, you do not have to buy insurance.
If your policy was in effect on March 23, 2010, and you made no changes to it since that time, your policy is a grandfathered policy. You can keep that policy. You do not need to shop for a new policy.
If your policy was in effect on March 23, 2010, but you made significant changes to it since then, such as increasing your deductible, coinsurance, or copayments, or dropping maternity coverage, then your policy is no longer a grandfathered policy. It is a reform policy. When you renew your coverage, you will be on a reform-compliant policy (or non-grandfathered policy.)
A detailed chart on what provisions apply or do not apply to grandfathering is available in the HHS regulations.
Check your plan's materials to determine grandfather status. You may also need to check with your employer or your health plan's benefits administrator.
Open enrollment begins on Nov. 15, 2014.
There are four easy ways to get coverage.
The policies purchased between Nov. 15 and Dec. 15 will not go into effect until Jan. 1, 2015.
You always choose your own doctors. How much your insurance pays will be determined by whether the doctor you choose is in the provider network used in your insurance plan. To see what networks you doctor is in go to www.bcbsla.com/findcare.
We encourage everyone to work with brokers or agents. They can help you sign up for the right coverage for you. They are experts in health insurance and they can help you understand what you are buying. And they're free! Find an agent near you!
The government is requiring that every health insurance plan cover a minimum set of benefits – from doctors to drugs to hospital visits. We call these essential benefits. Some of these essential benefits include emergency room services, maternity care, mental health, lab services and pediatric dental and vision care.
Most large employers will continue to run their health plans as they do now. Many aspects of the ACA do not apply to this group. So you won't see much change.