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                      The Affordable Care Act...............Ready, set, go..............October 1, 2013

 

            The centerpiece of the Affordable Care Act is a new system that enables individuals to choose

and purchase individual health insurance through “marketplaces.”  The marketplaces open for business on October 1, 2013.  This year the marketplace open enrollment runs from October 1, 2013 thru March 31, 2014.  In subsequent years, the marketplace will operate with the same schedule as Medicare open enrollment; October 15th thru December 7th. 

            Think of the marketplace as a virtual insurance store.  Millions of New Yorkers will be able to sign up for a plan of their choice, with no questions asked about their medical history.  Many New Yorkers will be entitled to income-based tax credits that will help them pay their premiums. 

            Many people argue that the new health law will upend the health insurance of practically everybody.  At least 80 % of Americans will notice no change at all because they already have insurance that meets the law's requirements.  This figure includes the 49% of people who get health insurance through their or someone else's job, as well as people who get insurance through the government.  This includes Medicare, most Medicaid coverage health insurance for children in low-income families, and Tri-care (health insurance for military and their families)

 

                                                             Your ACA Watch List

 

1.      By October 1, 2013, your employer will give you a form called “New Health Insurance

                                     Marketplace Options and Your Health Coverage” 

2.      You have health insurance through your job, but it is very expensive (it costs you more than 9.5 % of your household income), the state marketplace might be a better option for you. There are limitations to this option,         so hold on to all forms you are given. The law gets tricky here, and it would be a good idea to speak to a professional in order to sort this out.

 

It's Important to know................

            Health Insurance Plans for businesses and individuals that take effect on or after January 1, 2014, must offer “essential health benefits”  These include, emergency services, hospitalization, laboratory tests, maternity and newborn care, management of chronic diseases such as diabetes, mental health and substance abuse treatment, out-patient care, pediatric services including dental and vision care, prescription drugs, immunizations, mammograms and colonoscopies and rehabilitation and habilitation services.

            No private health plan gives unrestricted access to doctors and hospitals.  Every plan has a network of doctors and hospitals, labs, imaging centers, and pharmacies that provide services to plan members at a contracted price.  Every marketplace must provide a directory of participating providers that you can consult before you make your final plan selection. 
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