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The Affordable Care Act (ACA) and Your Family

Your Family and You: What the Affordable Care Act Covers for Your Family and You

By Addy Reeds

The Affordable Care Act has changed the way Americans can get health insurance, and it has made changes to the laws governing health insurance providers. Under the new laws, certain health services must be covered by all insurance companies. There are other changes to health care laws that all Americans should know about.

Mandatory Health Insurance for Most People

It is now mandatory that all Americans have health insurance if they can afford it. Anyone who does not get health insurance through their job or who is not covered by Medicare or Medicaid must purchase health insurance or risk having to pay a penalty. Some people may be eligible to have the penalty waived.

Marketplace Health Insurance

The government’s marketplace allows individuals, couples or families to shop for health insurance and determine if they qualify for tax credits or subsidies that will lower the cost of their monthly premiums or co-payments. Eligibility for tax credits and subsidies is based on household income. Those who do not qualify for tax credits or subsidies may be eligible for Medicaid in their state. Those who do not qualify for tax credits or Medicaid are exempt from the mandatory health insurance requirement and will not have to pay a penalty if they choose not to purchase health insurance. Employers can shop at the Marketplace for group insurance for their employees. The website has a special section for commercial or group insurance.

Pre-existing Conditions

Health insurance companies are no longer allowed to deny coverage to people because of pre-existing medical conditions, or to impose waiting periods for pre-existing condition coverage.

Guaranteed Coverage

Health insurance plans must now cover certain procedures, including prescription drugs and pediatric services including dental and vision.

Prescription drug coverage under all health insurance plans is one of the most dramatic changes that has come with the new health care laws. This does not mean that everyone with health insurance gets prescription drugs for free, however. It does mean that your health insurance must cover prescription drugs, but they may make you pay a co-pay or co-insurance payment. There are some preventative tests that now must be offered under all plans free of charge. These include: blood pressure screening, cholesterol screening, cholorectal screening for adults over 50, depression screening for adults and Type 2 Diabetes screening for adults with high blood pressure. A complete list of free preventative procedures can be found at the government’s healthcare.gov website.

Informational credit to:

InsuranceAgencyRaleigh.com – Carter Insurance offers a vast variety of insurance to Raleigh, NC and neighboring cities.

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