The Affordable Care Act, also known as the health care law, was created to expand access to affordable health care coverage to all Americans, lower costs, and improve quality and care coordination. Under the health care law, people will have:
- health coverage that meets a minimum standard (called "minimum essential coverage") by January 1, 2014;
- qualify for an exemption; or
- make a payment when filing their taxes if they have affordable options but remain uninsured.
In 2014, Health Insurance Marketplaces will be a new way to find health coverage. On the Marketplaces, some people may be eligible for lower costs on health premiums and out-of-pocket costs based on their income.
To determine eligibility and to sign up, go to Covered CA: www.coveredca.com
More helpful websites and handouts to learn about ACA:
When and how can I sign up?
Starting October 1, 2013 you can sign up for health insurance under the Affordable Care Act (ACA). The last day to sign up for coverage is March 31, 2014.
You may also go to www.healthcare.gov to learn about plans in your area - you may also call 800-318-2596. These resources can also help you find out if you can get financial help with your plan or perhaps a tax credit.
What information will I need to sign up on the website?
Be ready with your social security number, income information and policy numbers of health insurance plans currently covering your family members. Health insurance coverage can start as soon as January 1, 2014. The sooner you sign up, the sooner your coverage will begin.
Who should be looking to buy insurance on the ACA exchanges (Covered CA)?
Those who don't have insurance now and those who currently purchase their own insurance (meaning they don't get it through an employer).
How will the exchange work?
You do it all online. Each state has its own website (California = Covered California). You go to the website (www.coveredca.com), provide some basic information (like where you live and how old you are) and you'll get a list of plans available in your area.
What if I need help going through the process?
Call the Covered CA line (800-300-1506). There are trained people there called assisters and navigators who can walk you through the process.
When does my coverage start?
If you sign up by December 14, your coverage can start as early as January 1, 2014.
What kind of benefits will I get?
All plans will at least cover the following:
- outpatient care
- emergency services
- hospital care
- mental health and substance abuse care
- lab work
- prescription medicines
- wellness services
- pediatric care
- maternity and newborn care
Plans will also give you some services that PREVENT illness for free. You will not be charged a co-pay or deductible for these. Birth control that requires a prescription will also be available for free. Here are some of the free services:
- blood pressure screening
- cholesterol screening
- colo-rectal cancer screening
- depression screening
- diabetes screening
- diet counseling
- HIV screening
- vaccines for adults
- tobacco use screening
- mammograms for women
- cervical cancer screening for women
- osteoporosis screening for women
Do I really need it?
If you already have health insurance, such as through your job, you may not need to sign up. But you must have a certain amount of health insurance - otherwise you risk being fined. This fine will get bigger over the next few years.
What will my options be?
You will be able to pick from plans that have different premiums, co-pays, deductibles, and coverage. Different plans will work with different providers. Make sure your provider is "in network" if you want to keep seeing him/her. Also, check the plan to make sure your medicines will be covered.
What else can I do to decrease costs?
You may get lower costs if you don't smoke and if you try to keep a healthy weight.
Can I be turned down by a plan?
You can't be turned away or charged more because of a condition you already have. You can't be charged more for a plan if you're a woman. There are no lifetime or yearly spending limits on your care.
Are you on your parents plan and under 26?
What's the Health Insurance Marketplace?
Beginning in 2014, the Marketplace is a new way to shop for and purchase private health insurance (for example, health coverage other than VA health care programs) that fits your budget and meets your needs. People who purchase insurance through the Marketplace may be able to lower the costs of health insurance coverage by paying lower monthly premiums. (www.healthcare.gov)
What happens if I do not have health coverage?
You do not have to make a payment if you have coverage that meets a minimum standard (called "minimum essential coverage"). If you have access to affordable coverage but remain uninsured starting in 2014, you may have to make payment when filing your taxes. This payment will either be a flat fee or a percentage of your taxable household income, depending on which amount is higher. This payment will be phased-in according to the schedule below:
- $95 or 1% of your taxable income in 2014
- $325 or 2% of your taxable income in 2015
- $695 or 2.5% of your taxable income in 2016
Exemptions from the payment will be granted under certain circumstances. For more information on these exemptions, visit www.healthcare.gov.
If I'm enrolled in a VA health care program, do I meet the requirement for health care coverage?
Yes. If you are enrolled in any of VA's programs below, you have coverage under the standards of the health care law:
- Veteran's health care program
- Civilian Health and Medical program (CHAMPVA)
- Spina bifida health care program
Where can I get more information about veterans and the ACA?
[from "Questions and Answers About the Affordable Care Act" (Prescriber's Letter, September 2013; and from "VA Health Care and the Affordable Care Act: Frequently Asked Questions" (June 2013)]