Pretty soon there will be new healthcare laws going into effect. I’m sure many of you are confused as to what this means for us. I was confused too, which is why I did a Virtual Briefing with other Bloggers through The Motherhood and WellPoint, known locally as Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Georgia and Empire Blue Cross Blue Shield.
Our country is essentially in the beginning of a health care reform, referred to as Affordable Care Act (ACA) or ObamaCare; which will change the way that many of us get insurance coverage. Each and every American will be required to have health insurance or face tax penalties if they don’t. The intention behind this health care reform is that every American will have access to affordable health care.
Open enrollment starts on October 1st and will continue through March 31st of next year. Through this system or Marketplace as it’s referred to, people will be able to buy healthcare for individual and/or family benefits – regardless of pre-existing conditions. There are “essential benefits” that are included in each plan such as maternity benefits, newborn care and emergency services – among others.
The tax penalties were put into place because they believe that this will only work if everyone is a part of the pool. People who use a lot of insurance will balance out those who use little – which sounds like a great concept. However, I still am not seeing how this will work in the end. This concerns me quite a bit and we really didn’t talk numbers in that aspect.
Now if you don’t buy insurance for whatever reason – even if it’s because you simply can’t afford it; you will be taxed 1% of your annual income or $95 per individual, $285 per family. You will pay whichever amount is greater. The goal here is for people to see the benefits of health coverage, though I’m still not seeing it. If you can’t afford it, you can’t afford it. An added tax expense certainly won’t get you any closer to affording it either! I think common sense really went out the door on this one!
Health insurance will be purchased on an exchange, similar to shopping on Amazon or Expedia. You will be able to comparison shop for four metallic levels of coverage, depending on how much coverage you want – or more important, how much you are willing to spend.
“There will be four levels or metallic tiers, depending on how much you want to spend. The general rule is that your deductible will be lower, the more you spend on your monthly premium. So for example, at the Platinum tier, 90% of your expected cost will be covered, but you will pay higher monthly premiums. A gold plan will cover 80% of your costs. A silver plan will cover 70% and a bronze plan will cover 60%.At each level, there will be a few health plan options to choose from. And you will be able to choose your own in-network primary care physician, OB-GYN and pediatrician without a referral. Co-pays and deductibles will vary depending on the plan you select.”
Some people may qualify for financial help. If an individual makes less than $45,000 or a family less than $92,000 each year, then they will qualify for assistance – those making less money receiving the most assistance.
Here are some websites you can visit to learn more about all of this:
Healthcarereformforyou.com
Healthcare.gov
The Kaiser Family Foundation at Kff.org
Now, there are reasons we need healthcare and I get that. The costs especially are a major factor. The average 3 day hospital stay is $30,000. That amount could certainly put a lot of families in debt very quick! Even a broken arm will cost you about $2,500 and that’s without needing surgery. Looking at these numbers, maybe healthcare workers could take a small pay cut to make these more affordable! People used to go into medicine to help people, but nowadays many go just for the profits.
Basically, these are the 4 options that you will have regarding healthcare over the next year.
- Continue purchasing insurance through your or your spouse’s employer
- Buy health insurance yourself – either through exchanges, direct for insurance companies or through traditional brokers
- Enroll in government programs like Medicare or Medicaid plans – if you are eligible
- Go without insurance – but pay a tax penalty
