Although the Patient Protection and Affordable Care Act (PPACA) was passed in 2010, its goal of ensuring affordable hospital service for millions of Americans will not be fully implemented until 2014. The national health reform, commonly referred to as Obamacare, is broad and affects virtually everyone: patients, employers and the health insurance industry. This article will better explain how it works. In any case, you do not "get" this initiative in itself: it is a law that changes the entire insurance coverage, to allow all citizens to have easy access to health infrastructures.
Steps
Method 1 of 6: History of a Change
Step 1. Obamacare was approved in March 2010 and will go into full effect in 2014
Step 2. All states will need to have an insurance package ready in January 2014, which will provide basic health benefits as required by the Sec Act
1302 (a) of the law. If some states opt to establish their own program, the Department of Health and Human Services will enrich the package with state assistance. Either way, wherever you live, you will have access to coverage. Go to USA.gov and take a look at the list of states. Once you have found your web page, click on the Affordable Care Act link or go directly to the Department of Health and Human Services for information.
Step 3. Citizens can still subscribe to individual insurance plans before January 2014, but insurers will have to enter new details, such as allowing children to re-enter their parents' policies up to the age of 26 and not setting a lifetime cap on the coverage. (on the internet you can compare the plans and rates of health insurers)
Method 2 of 6: Get an idea about the Obamacare
Step 1. You cannot be discriminated against by an insurance company if you have a pre-existing condition:
this is illegal.
Step 2. You will be able to purchase an affordable medical insurance package
As of 2014, it is possible to get the same health benefits traditionally offered at a much higher cost by private insurance companies. If your employer doesn't offer you an insurance plan, you can still purchase the same package privately or through the Affordable Insurance Exchange.
The packages will feature a variety of health plans that will guarantee certain standards (even members of Congress will get them this way)
Step 3. A qualified health plan will need to be certified and provide the benefits listed by law
The insurance company must offer at least two levels of coverage: silver and gold.
Step 4. Small businesses will have a tax deduction for offering health plans to their employees
Step 5. Insurers will need to be transparent
The service provider will be obliged to tell you the sum of the administrative costs and to reimburse you if the costs are unusually high. This means that insurance premiums will primarily be used for your health coverage, not administration.
Step 6. Those who retire early will get extended coverage:
the law provides for a replenishment of funds for this category of people to obtain health coverage from their former employer for as long as they are eligible for Medicare.
Step 7. The insurance coverage limits will not have a lifetime cap (and after January 2014 there will be no annual caps either)
Step 8. You cannot be dropped from a policy if you have a serious and long-term illness
Step 9. Parents can provide insurance coverage for their children up to the age of twenty-six, which means that you will be able to provide them with health insurance for the duration of college
Step 10. Low income individuals are eligible for health insurance premium tax deduction
From January 2014, they will be able to obtain the credit (even if they have no tax liability) and decide that the tax deduction be paid in advance directly to the insurance company of their choice. This credit will be applied to the prize.
Method 3 of 6: Obamacare Preventative Coverage for Adults
Step 1. Insurers will need to provide coverage for preventive health procedures without imposing additional fees or dues to be paid by the patient
Your insurance plan must include preventive projections for:
- Abdominal aortic aneurysm.
- Alcohol abuse (including therapy).
- Aspirin (age restrictions for heart attack prevention).
- Blood pressure.
- Cholesterol (restrictions for age and for high-risk patients).
- Colorectal cancer (age restrictions).
- Depression.
- Type 2 diabetes (for high-risk adults).
- Diet (for adults at high risk of food-related conditions).
- HIV (for high-risk adults).
- Immunization (Doses and age restrictions vary according to risk. See Vaccines.gov for adult vaccinations).
- Obesity.
- Sexually transmitted diseases (including syphilis).
- Use of tobacco (including treatment after cessation).
Method 4 of 6: Obamacare Preventative Coverage for Women
Step 1. Since August 2012, the following prevention services are covered at no additional cost:
- Breastfeeding (support, assistance and supplies).
- Contraception (FDA approved sterilization methods and procedures; abortion-inducing drugs not included).
- Domestic violence (including psychological therapy).
- Gestational diabetes (for high-risk women).
- HIV (psychological assistance included).
- HPV.
- Sexually transmitted diseases.
- Well-woman visits (to receive advice on recommended preventive services).
Step 2. The following preventive services for women will be provided at no extra cost from January 2014:
- Anemia.
- Bacteriuria (urinary tract infection) for pregnant women.
- BRCA (genetic test for women at high risk of breast cancer).
- Mammography (every two years for women over 40).
- Chemoprevention for breast cancer.
- Cervix cancer.
- Chlamydia.
- Folic acid (supplements for pregnant women).
- Gonorrhea (for high-risk women).
- Hepatitis B (first antenatal visit).
- Osteoporosis (for women over 60 and for those at high risk).
- Incompatibility of RH (for pregnant women).
- Use of tobacco.
- Syphilis (for pregnant women and those at high risk).
Method 5 of 6: Obamacare Preventative Coverage for Children
Step 1. Preventive examinations and supplements will apply up to age 18
Some tests and procedures are restricted by age or by recommendation:
- Alcohol and drug use.
- Autism.
- Behavioral and developmental assessments (including depression).
- Blood pressure.
- Congenital hypothyroidism and dyslipidemia.
- Chemoprevention with fluoride and oral hygiene tests.
- Tests for infants, including those for preventive medication for gonorrhea, sickle cell anemia, phenylketonuric syndrome, and hearing.
- Measurement of height, weight and body mass index and test for obesity.
- Hemoglobin.
- HIV tests and assistance for the prevention of sexually transmitted diseases for high-risk adolescents.
- Vaccines for immunization.
- Iron supplements (for children at risk of anemia).
- Lead poisoning (for children at risk of exposure).
- Medical history for all children during development.
- Tuberculin test for children at high risk of tuberculosis.
- Eye test for all children.
Method 6 of 6: How Obamacare Affects Medicare
Step 1. Obamacare was approved with the intent to eliminate Medicare fraud and to reduce the amount of payments made to Medicare Advantage programs that private insurance companies offer in their health plans (there will be payment cuts Medicare for doctors, but plans for these reductions were put in place during the Clinton administration and postponed to 2002, so they have nothing to do with Obamacare.)
Step 2. Reductions in Medicare payments to physicians will not affect professionals over 55
However, without further provisions and changes under the current law, it is possible that Medicare benefits will start to be cut in 2022.
Step 3. High-income senior doctors will receive reduced prescription drug subsidies
Step 4. A committee of industry experts (called the Independent Payment Advisory Board) will have the power to make cuts in line with Medicare costs
The commission was prohibited from the following actions:
- Rationing care.
- Raising costs for retirees.
- Narrow down the benefits.
- Raise the age considered eligible for Medicare.
Step 5. Senior citizens will receive $ 250 on their medical prescriptions to fill the void commonly known as the donut hole, a period during which spending limits preclude drug coverage
Advice
The actual process of purchasing health insurance doesn't really change; the law will change coverage, availability and cost
Warnings
- The Independent Payment Advisory Board has not yet been formed. Members must be confirmed by the US Senate. If you are concerned about this aspect of the law, you should keep up with the nomination and confirmation process.
- Obamacare is not a panacea. Problems, questions, revisions and corrections will not be missing. Visit Healthcare.gov regularly to learn about proposed changes to the law.
- This article touches on the main points of the new law. The actual program consists of 2,700 pages. You can read it in its entirety at Healthcare.gov.
