Affordable Care Act (ACA): Review of Some Key Points

Posted on September 1, 2013

Many clients are confused about how the Affordable Care Act  (ACA) (Obamacare) will affect them and their health care coverage.  Here is some information that may be useful:

  • Beginning in October, 2013, if you are uninsured, if you’ve been denied coverage in the past, or if you want to explore new options, you can purchase health insurance at the ACA Health Insurance Marketplace at HealthCare.gov.
  • The Health Insurance Marketplace is a set of government-regulated and standardized health care plans from which individuals may purchase health insurance. It is a one-stop shop for a health care plan, to compare benefits and prices, and choose the best plan. No matter in what state you live, you will be able to use the Marketplace to apply for coverage, compare your options, and enroll.
  • Private companies will run plans in the new Marketplace and every health insurance plan will cover a core set of benefits called “essential health benefits”.
  • The Kaiser Family Foundation website has a tool, ” Subsidy Calculator” that illustrates various health insurance premiums for people purchasing insurance in the Health Insurance Marketplace.
  • The Health Insurance Marketplace open enrollment dates are October 1, 2013 through March 31, 2014. Coverage begins January 1, 2014.
  • Important to know: No one can be denied coverage because they have a pre-existing condition.  Low cost and free plans are available and financial help is available based on a sliding scale for financial assistance.
  • You can speak to an expert at no charge, an ACA Navigator, by phone, online or in person, who will answer your questions and help you choose the plan that is right for you.   Note that insurance brokers or salespeople are not permitted to be ACA Navigators. Go to HealthCare.gov or call 1 800-318-2596 to get more information.
  • Please know: Medicare coverage is protected. If you have Medicare now, the ACA will not affect your coverage.  Nothing will change for you. Under the health care law, your existing Medicare-covered benefits will not be reduced or taken away. You don’t have to replace your Medicare coverage with Health Insurance Marketplace coverage.
  • Under the ACA, Medicare now covers certain preventive services, like mammograms or colonoscopies, without charging you for the Part B coinsurance or deductible. You also can get a free yearly “Wellness” visit.
  • Review the “Health News” blog at NPR for answers to some commonly asked ACA health insurance coverage questions.

 

  • Beware of Scams: Scammers are exploiting the confusion over the ACA to steal your credit card, Social Security, and bank account numbers.
  • According to the Federal Trade Commission (FTC), consumers need to just hang up on telemarketers claiming to be “from the government” offering “Obamacare cards,” and even threatening jail time for people who do not buy health insurance.
  • The scammer’s call might go like this:

“Good morning. I’m calling from the government. We’re about to send out national Obamacare medical cards for the new Affordable Care Act. You’re one of the lucky people to get yours first, so I just need to confirm your name, address and phone number. Oh, and your bank account number, too…”

  • In a related scam targeting Medicare enrollees, scammers claiming to be “from Medicare” tell consumers that Obamacare requires them to report their personal financial information in order to keep getting benefits. They may even claim that Obamacare is replacing Medicare, which is not true.
  • The truth is that the Affordable Care Act does not affect the benefits of current Medicare enrollees. For more information: http://usgovinfo.about.com/b/2013/08/26/obamacare-card-calls-are-scams.htm
  • Scammers are also creating websites that sound legitimate but are not!  Do not be fooled into giving your personal and financial information on fake websites. Remember: the only official website is HealthCare.gov.
  • The Better Business Bureau (BBB) offers the following tips to people who experience the ACA healthcare scams:
  • If you get one of these calls, just hang up. You may be tempted to call back, but this will only give the scammer another opportunity to steal your information. Also, be sure not to press any buttons that the scammer instructs.
  • Never give out personal information. Never give out your bank account numbers, date of birth, credit card number or social security number.
  • Don’t rely on caller ID. Some scammers are able to display a company’s name or phone number on the caller ID screen. Don’t trust that the information you see is true.
  • The government rarely communicates via phone calls. Most of the time, the government uses traditional mail to communicate to consumers. The government rarely calls, emails or texts, so don’t give your information to these types of government messages.
  • For more tips and information about healthcare scams, visit http://www.bbb.org/.