A,B,C s of Obama Care What do you need to know? How will it affect you and your family?

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1 Elephant in the Room A,B,C s of Obama Care What do you need to know? How will it affect you and your family? Confused? What will you learn in this webinar? O What is Obamacare? O What has it done so far? O What do you need to know about it? O How will it affect you and your family? What is Obamacare? The Patient Protection and Affordable Care Act Health Care Reform Signed into law March, 2010 Contains thousands of pages of reforms The goal? To cut healthcare costs and provide affordable health care to all 1

2 What has happened so far? O Stay on parent s insurance until age 26 as opposed to 18 O Bans health insurance companies from denying coverage to children under 19 because of a preexisting medical condition. O Insurers are now prohibited from imposing life time dollar limits on * essential benefits such as hospitalization. What has happened so far? O All new insurance plans must cover preventative care without charging a deductible or co-pay. O Insurance companies cannot drop an individual off the policy if they get sick. O Insurance companies must prove that they spend 80-85% of the premiums on actual health care, not on salaries, bonuses, marketing etc. If they don t they must provide a refund to policy holders. What do you need to know? Beginning January 1, 2014 nearly everyone will be required to have health insurance. Nearly?? Who is notrequired to have health insurance? And everyone else? ½ are covered at work, 1/3 by medicare/medicaid, 1 in 10 will need to buy insurance and just under 1 in 10 still won t have any. O Indian Tribe members O Illegal immigrants O Inmates O Those religiously opposed O Those who do not earn enough to pay federal income tax ($10,000 for individual and $20,000 for a family) O Those whose health insurance would exceed 8% of their income. 2

3 You can get insurance through: O your employer O a broker O Medicaid or Medicare O (For Children) the Children Health Insurance Program O a veterans health program or Tricare for service members and their families O The Marketplace Penalty O In $95.00 per adult; up to $ per family. O In $ per adult and $2085 for a family On Medicare? You don t need to do anything. On Medicaid? You don t need to do anything either. For those needing to buy insurance, the Marketplace has been created to provide a place to shop for policies. The Marketplace O Go to O Options for insurance in New Hampshire? 3

4 Levels of Coverage Metal Levels Level of Coverage Bronze Silver Gold Platinum Plan Pays 60% 70% 80% 90% Open for Business Year 1- Oct.1 - March 31, 2014 Following years -enrollment will be October 15- December 7 The Marketplace Tax deductions and subsidies O When you buy insurance through the marketplace you can get payment assistance such as: O cost sharing and reductions in deductibles O Tax deductions The role of the IRS Subsidies Individuals: $11,490 - $45,960 Family of 4: $23,550 - $94,200 Health Reform Subsidy Calculator The Kaiser Family Foundation calculator Or just search Health reform subsidy calculator and click on the Kaiser website. 4

5 In the Marketplace When you fill out the application it will tell you: O if you qualify for lower costs O are eligible for Medicaid O are eligible for children s health insurance O Online chat The Market Place Help is available O Toll free # O People in your community Navigators- Application Assisters- Certified Application Counselors O Go to Help in your community O Health centers O Planned Parenthood O Bi-State Primary Care x 160 How will these changes affect you and your family? All insurances must offer the Essential Health Benefits Essential Health Benefits O 1. Wellness & disease management O 2. Prescription drugs O 3. Hospitalization O 4. Laboratory services O 5. Emergency services O 6. Maternity & newborn care O 7. Children s care, dental & vision O 8. Rehabilitation & habilitation O 9. Mental, behavioral health & substance use care O 10. Outpatient clinic services 5

6 You can t be turned down. Can t get turned down or charged extra.. O Plans cannot charge on the basis of gender or health problem O Mental health care is paid at the same level as other types of care. O No lifetime caps on basic health or mental health care. O No refusal of coverage for pre-existing condition Let s Recap O NH Marketplace opened Oct. 1 O Buy insurance or be fined O There is financial help available O Help available to apply O You can t be denied O Covers all essential health benefits O More choice in 2015 Questions? The preparation of this webinar was financed under an Agreement with the State of NH, DHHS, Division of Behavioral Health, with funds provided in part or in whole by the State of NH and/or United States Department of Health and Human Services. 6

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