All plans will have the 10 essential benefits as dictated by the ACA. They will include hospitalization, emergency services, ambulance, maternity, mental health, prescriptions, rehabilitation, laboratory and X-rays, preventative and pediatric.
There are some exceptions to those who must have coverage by January 1st, but primarily it is anyone covered by an employer plan or someone already on an individual plan. So if you don’t currently have medical coverage it is very important to talk to someone who has knowledge about the new plans. You have different options available to you in getting more information specific to your situation.
You can go to Washington Exchange website- www.wahbexchange.org for current information. There are non-profit organizations providing pathfinders – who are there to help guide you through the system. And there are insurance agents, like myself, who can addressyour specific situation and figure out if you should go through the exchange or not and whether you might qualify for a federal subsidy.
The open enrollment period goes from October 1, 2013 to March 31, 2014. Since everyone is eligible for coverage there will be no medical questions to be answered. Coverage will begin the month following enrollment after January 1, 2014. There will be penalties accessed on your tax return if you don’t get a medical plan by that April 1, 2014 deadline. Once again, people who are on a plan through work or have individual coverage don’t need to worry about this. It is primarily the people who do not have any coverage in place today.
There will be federal subsidies given to anyone who is making under 400 percent of the poverty level. In order to qualify for the subsidy you will have to purchase your coverage the Washington Health Benefit Exchange. This is expanding the program that is currently in place to help the low-income.
Hopefully this gives you a brief overview of the ACA and gets you thinking about checking into your own health coverage. If you don’t currently have coverage, then you need to talk to someone approved by the Exchange right away!