As the healthcare plan conceptualized and signed into law by President Barack Obama faces it’s toughest scrutiny before the United States Supreme Court, the perceived over-reach of the U.S. government has been debated over as some people take offense to being told how to spend their money — even if it means the difference between life and death.
BlackDoctor.org has taken the time to break down the components of the Act and what exactly it means for you, your children, parents and extended family.
Now, you can read the details for yourself in laymen’s terms:
BlackDoctor.org) – How will the new health care law benefit me and my family?
Children. Health insurance companies can no longer deny coverage to children who have pre-existing medical conditions. A pre-existing medical condition is a condition that a person has or has received treatment for before applying for health insurance coverage. New health plans (those that do not have “grandfather” status under the law) are also required to cover the full costs of immunizations for children. This means that you don’t have to pay a co-payment or deductible to have your child vaccinated under these plans.
Adults. New health plans are required to cover all costs associated with preventive services for men and women. This means you don’t need to pay a co-payment or deductible for preventive services under these plans. Preventive services help you stay healthy. The types of preventive services you need depend on your gender, age, medical history and family history. Examples of preventive services include diabetes screening, some vaccines (such as the flu shot), Pap smears for women and prostate cancer screenings for men.
Also, if you are 26 years of age or younger, you can remain a dependent on your parents’ private health insurance plan even if you do not live with them and are not a student.
How will the new law benefit seniors?The law benefits Medicare patients who hit the coverage gap (“donut hole”) under the prescription drug benefit. The coverage gap is a period of time in which you have to pay for all your prescription drug costs yourself. In 2010, enrollees who reached the coverage gap under Medicare Part D received a $250 rebate from Medicare.
Starting in 2011, enrollees received a 50% discount on brand-name prescription drugs covered by Medicare Part D. The discount will begin to increase starting in 2013 until enrollees pay just 25% of the cost of brand-name drugs in 2020.
Starting in 2011, enrollees also received a 7% discount on generic drugs covered by Medicare PartD. The discount will grow 7% each year until enrollees pay just 25% of the cost of generic drugs in 2020. If you are a Medicare patient, you no longer have to pay any costs associated with preventive services that Medicare currently offers. Starting in 2014, the oldest people in a health insurance plan will pay no more than 3 times the rate paid by the youngest people in the plan.
I don’t have health insurance. Will I have to get it?
Probably. Under the law, most Americans will have to have health insurance by 2014. If you don’t have health insurance and don’t meet one of the exceptions listed in the law, starting in 2014, you will need to pay a penalty. The penalty can be as little as $95 per adult and $47.50 per child (with a maximum penalty of $285 per family per year) or 1% of family income, whichever is higher. The penalty will increase to $695 per adult and $347.50 per child (with a maximum penalty of $2,085 per family per year) or 2.5% of family income income by 2016.
Native Americans, individuals who have religious objections and those with a financial hardship can avoid the penalty.
What if I can’t afford health insurance?
If you can’t afford health insurance, you may qualify for Medicaid. Under the law, states have the option of expanding Medicaid to cover everyone who earns less than 133% of the federal poverty level. (This expansion will be required by 2014.) This means that the Medicaid program in your state may cover you if you are an individual who has a yearly income of less than $14,856 in 2012 or if your family of 4 has a yearly income of less than $30,657. For larger families, incomes can be higher.
If you don’t qualify for Medicaid but cannot afford the full cost of health insurance, you may qualify for financial assistance from the government starting in 2014. This financial assistance will help you purchase private health insurance through a state-based health insurance exchange. This exchange will allow you to compare benefits and prices among several insurance plans to decide which one meets your needs. All insurances in the exchange will offer at least a minimum benefit package. They will also offer other coverage options beyond the basic plan. Depending on your income, you will pay from 2% to 9.5% of your income for insurance. The government will cover the rest of the costs.
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