How does the Affordable Care Act Work

The Affordable Care Act

Health Insurance is one of the essential forms of insurance, but most people cannot afford it. Affordable Health Care Act has been successful in conducting affordable health care to millions of people in America. This affordable health care act made some changes to the tax code to intent on increasing health insurance coverage. The ACA gave a wide range of coverage of health insurance to more than 20 million people. ACA or also known as Obamacare, has a lot of benefits that most people don’t have any idea. The main goal of the ACA is to lower the United States health care costs. This act wants to accomplish insuring more people and give them better coverage. The time the law has passed, more than 20 million residents don’t have healthcare insurance. It intends to make that coverage possible and so make the coverage more useful.

How does the Affordable Care Act Work

Health care in the United States has some serious long term issues. There are millions of uninsured people, and people who do have insurance are inclined to pay more for it than they would in other comparable countries. Affordable Care Act’s goal is to fix these problems by making accessible health care available to more Americans. In achieving this act, some changes need to happen. However, these changes phase in overtime instead of happening all at once. There’s a lot of things that will stay the same as if you are already insured that you are happy with it, you can keep it under this law. As well as children under the age of 26 can stay on their parent’s plans.

Changes in the Affordable Care Act

First, there’s this thing called the individual mandate. Most Americans will be required to have some form of health insurance. It is an extensive change for a country with more than 20 million uninsured residents. How can you enforce to apply that? In 2014, each and everyone that does not have health insurance was in need to pay for a small fee. During that year, the cost is going to $95 per adult and $47.50 per child. Those numbers are over the whole year, not month by month. Making sure that people can find affordable insurance, the affordable act creates Health Insurance Marketplaces. It is a virtual space run by the federal government, or by your state, where customers can find different plans and prices offered by insurance providers.

Eventually, this might allow you to qualify for lower premiums, depending on your income and family size. That no matter what kind of insurance you have, insurers are no longer be able to deny or revoke coverage for pre-existing conditions (No penalties for pre-existing conditions). Women won’t have to pay more than men for insurance either. Insurance will also cover preventative care, like mammograms, checkups, and screenings. Additionally, there is an 80/20 rule that insurers are generally required to spend at least 80% of the money they get from premiums on actual health care. If insurers consume too much on overhead, at that time, you’re going to receive a rebate. Lastly, the law also requires an institution to justify rate increases of over 10% publicly. Besides, they are banned from imposing lifetime dollar limits on benefits. This act may also affect your employer, even if you work for a large company or a smaller company.

A smaller business, one with less than 50 employees, can visit the small business health options program, to compare and purchase affordable health plans. In 2015, they had to make called an employer shared responsibility payment if they don’t provide insurance to meet a minimum value standard if one of their employees gets a better deal in the individual marketplace.

How the Individual Mandate Affects the Health Insurance Market

The huge change that brought the most significant transformation to the health insurance industry is the individual mandate. The individual mandate is a requirement to very Americans to carry health insurance or else pay a tax penalty. This law held health payers to cover more individuals and families than before. In the health insurance industry, there are many covered people due to this source of subsidy to be able to purchase health insurance.

Medicaid Advantage Plan

It’s health insurance that you get from the government. It is an extensive coverage for people that may have a low income or have certain health conditions. Eligibility can be varied by income, household size, or citizenship status, depending on your state. Most Medicaid plans let you pick your primary care provider (PCP). Your PCP is the primary professional that will take care of you. Medicaid plans offer a lot of help to stay healthy, and your policy may provide preventive care services as well as coverage for medications that are low or no cost to you depending on your policy. Medicaid may also include extra care and services.

Medicare Advantage Plan

Medicare health plan is offered by a private company that contracts with Medicare in providing you with all your part A and part B benefits. If you are covered in a Medicare advantage plan, most Medicare services are covered through the program and not paid under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage. Medicare Advantage plans are either the,

  • Health Maintenance Organization (HMO) Plans
  • Preferred Provider Organization (PPO) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNPs)

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