Affordable Care Act: 10 Things to Know

What Are MS Patients Shopping for in the Health Insurance Marketplace?
Jill K Leslie, Public Health Advisor

On March 23, 2010 the Affordable Care Act (ACA) became law and will create some important changes in our health care system.

For the more than 40 million people in the U.S. who do not have health insurance, the ACA was an anxiously awaited piece of legislation. If you are one of them—and do not have health insurance—you can shop in your state’s Health Insurance Marketplace beginning October 1, 2013 for coverage that could begin as soon as January 1, 2014.

Whether you need health coverage or have it already, the health care law also offers new rights and protections that make coverage fairer and easier to understand. Some rights and protections apply to plans in the Health Insurance Marketplace or other individual insurance plans, some apply to job-based plans, and some apply to all health coverage. One important component of the ACA relates to pre-existing conditions. For years many patients with chronic diseases lived in fear of losing their health insurance, afraid that if they changed or lost their job they could never be insured again. Thanks to the ACA, the approximately 250,000 to 350,000 people in the U.S. who have been diagnosed with MS can breathe a bit easier. Starting in 2014, most health insurance plans cannot refuse to cover you or charge you more because of a pre-existing health condition.

Additionally, the Marketplace cost-sharing reduction may lower the amounts you have to pay on deductibles, copayments, and coinsurance when you get care. This savings is based on your income and family size. If you’re unemployed you may qualify for Medicaid, the Children’s Health Insurance Program (CHIP), or lower costs on Marketplace insurance based on your income.

Frequently many MS patients delay care for fear of medical bills—fear that the ACA will help alleviate. Don’t let high medical costs keep you away from your health care provider. Get the quality of care you deserve and don’t put off tomorrow what you can do today. Learn more by visiting HealthCare.gov.

Health Insurance Marketplace: 10 Things to Know
1. If you don’t already have health coverage, the Health Insurance Marketplace is a new way to find and buy health coverage that fits your budget and meets your needs.
2. Open Enrollment starts October 1, 2013, and ends on March 31, 2014. Plans and prices will be available then. Coverage starts as soon as January 1, 2014.
3. You can view and compare health insurance options online. Through one simple application, you can also have options tailored to your personal situation and find out if you might be eligible, based on your income, for financial assistance to lower your costs.
4. The same application will let you find out if you and your family members might qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP).
5. The information is all available online, but you can apply 4 ways: online, by phone, by mail, or in-person with the help of a trained assister or navigator.
6. Each health plan will generally offer comprehensive coverage, including a core set of essential health benefits like doctor visits, preventive care, maternity care, hospitalization, prescription drugs, and more.
7. There will be a Marketplace in every state, which will offer plans from private companies. You’ll be able to compare your health coverage options based on price, benefits, quality, and other features important to you before you make a choice.
8. Health insurance companies selling plans through the Marketplace cannot deny you coverage or charge you more due to pre-existing health conditions, and they can’t charge different premiums based on gender.
9. Marketplaces will be operated by your state, the federal government, or a partnership of the two, but each Marketplace will give you the same access to all of your Marketplace coverage options.
10. For more information, visit HealthCare.gov. Or call the Health Insurance Marketplace Call Center at 1-800-318-2596, 24 hours a day, 7 days a week. TTY users should call 1-855-889-4325.