Health Insurance

The Big Questions

What is the Affordable Care Act, and why do we need it?

The Patient Protection and Affordable Care Act, commonly known as Obamacare, was signed into law by President Barack Obama on March 23, 2010. It includes a broad range of reforms designed to make health insurance better and more affordable, rein in health costs and expand coverage among America's nearly 50 million uninsured. The act requires most Americans to have health insurance or face a penalty. It also makes it illegal for insurers to set dollar limits on coverage, drop you if you get sick or charge more or deny coverage because of a pre-existing condition.

How does the Obama health insurance law affect you?

Stethoscope on hundred dollar bills © isak55/Shutterstock.com

The Affordable Care Act, also known as Obamacare, is bringing sweeping change to America's health care system.

Find out what it means for you by answering a few questions.

First, do you currently have health insurance?
You're among the roughly 85 percent of Americans covered by health insurance, according to Census data.
Senior patient shaking hands with doctor © Alexander Raths/Shutterstock.com

How does Obamacare impact you? It depends. Is your insurance through:

Like 55 percent of Americans, you have health insurance through work.
The word 'Employee benefits' highlighted in green © Rafal Olechowski/Shutterstock.com

In all likelihood, the law has enhanced your benefits. However, you may notice new penalties and incentives so you stay healthy and help control costs. And there's a chance your employer may scale back benefits to avoid a tax on so-called Cadillac health plans.

If your work-based insurance is considered too expensive for someone who earns what you do, you might qualify for subsidized coverage in your state's insurance marketplace, or exchange.

Like about 1 in 10 Americans, you buy your own health insurance.
Patient paying cash to doctors after visit © Pressmaster/Shutterstock.com

It's possible your current plan will have to be replaced with one that meets new Obamacare standards. But even if you can keep your current coverage, you may want to shop around for a new plan in your state's health insurance marketplace, or exchange.

You're likely to find new options you didn't have before. And, depending on your income, you may qualify for a federal subsidy to help with premiums.

You're among the roughly one-third of the U.S. population with health insurance coverage provided by the government.
Medicare enrollment form and a Social Security card © zimmytws/Shutterstock.com

If you're a Medicare recipient, Obamacare is gradually closing the prescription drug "doughnut hole." That's the biggest impact on Medicare from the Affordable Care Act; be careful of con artists claiming there are other big changes.

If you're currently on Medicaid, you may find it's now easier to get low- or no-cost preventive care.

If you're uninsured, you're far from alone. The Census says 15 percent of the population has no health coverage.
Doctor listening to patient © Alexander Raths/Shutterstock.com

But starting next year, if you don't have health insurance you could face a financial penalty. You might avoid the penalty by shopping for a health plan on your state's health insurance marketplace, or exchange.

You will find a range of coverage levels and might quality for a subsidy to help pay premiums. You might even be eligible for Medicaid, if that program is being expanded in your state.

If you work, your employer may have to start providing health insurance, though that employer mandate has been delayed. The new benefits may be meager.

Do I really have to buy health insurance?

The Affordable Care Act's "individual mandate" requires all Americans, with a few exceptions, to have health insurance that typically offers "minimum essential coverage." Going without insurance could bring a tax penalty. For 2014, that penalty is 1 percent of your annual income or $95, whichever is higher, and $47.50 for each uninsured child, to a family cap of $285. The penalty increases to the greater of 2.5 percent of income or $695 per person by 2016. The penalty will show up as an additional tax or a reduction in your federal tax refund.

I can't afford to buy health insurance. What should I do?

Why do I need health insurance?

What's the difference between a deductible, a copayment and coinsurance?

What is health insurance?

More questions and answers »

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Sources: U.S. Census, Congressional Budget Office, U.S. Centers for Medicare & Medicaid Services, Organization for Economic Cooperation and Development, Associated Press.

How much health insurance should you have?

How much health insurance do you need?

The short answer: enough to help you and your family weather an unexpected illness or injury and/or manage chronic health conditions without undue financial hemorrhaging.

"You know you'll likely need something, even if you're a totally healthy person," says Amy Bach, executive director of United Policyholders, a San Francisco-based insurance consumer advocacy group. "For most people, it's about comparing deductibles, copays, benefit limits and reimbursement rates -- basically, everything that you could be responsible for -- and then any portion of services that would fall to you, such as hospital stays." Read more

Is an Obamacare catastrophic plan for you?

Finding adequate health insurance coverage can be a challenge, especially if you're strapped for cash. If an Obamacare "metal level" health plan -- bronze, silver, gold or platinum -- busts your budget, you might consider a "catastrophic" plan.

The catastrophic option under the health care law allows Americans to enroll in a plan "with relatively cheap premiums, that is going to protect them in the worst-case scenarios," says Cheryl Fish-Parcham, deputy director of health policy at Families USA, a Washington, D.C.-based consumer group.

Slim coverage, fat deductibles
Primarily reserved for people younger than 30, the Affordable Care Act's catastrophic plans cover three annual primary care visits and preventive services at no cost, including disease screenings and vaccinations. Beyond that, the patient pays all medical expenses out of pocket up to a steep deductible, generally $6,350 for individuals and $12,700 for families. Read more

6 health insurance options for college students

Each year, college students face a critical test that they probably don't hear about in any classroom: having the right health insurance to cover the costs of ailments and emergencies that may arise while they're in school.

Thanks to the Affordable Care Act, the health reform legislation more often known by the moniker "Obamacare," students now have at least a half-dozen health care choices.

"Five years ago, a student had very few options," says Jenny Haubenreiser, immediate past president of the American College Health Association. "Now, they have many options." Read more

Health Insurance Pulse Survey

Bankrate’s monthly Health Insurance Pulse survey is tracking how people feel about health care and health coverage in the age of Obamacare. Read more about the latest survey »

As far as you know, are there tax credits available through the Affordable Care Act to reduce the monthly price of health insurance?

Source: Bankrate.com Health Insurance Pulse survey, March 17, 2014.

Editor's note: Percentages may not equal 100, due to rounding.

Health Insurance Exchanges

If you need to buy a health plan to satisfy Obamacare's requirement that virtually every American must have insurance, you'll want to check out the new health insurance exchange in your state. The state exchanges, or marketplaces, allow you to compare plans and find out if you qualify for a government subsidy to help with the cost. Most exchanges will operate from the federal government's HealthCare.gov website, although 14 states and the District of Columbia are running marketplaces of their own.

 

State exchanges operated through federal HealthCare.gov site.

 

States operating their own exchanges on other sites.

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