Are you already insured?
If you're already insured through you're employer, you're in luck. You don't have to do anything.
Some policies have already changed under the affordable care act. Those changes include:
- Coverage for children under their parents' plan until they are 26 years old.
- A company can no longer drop your coverage if you become sick.
- Lifetime limits are no longer allowed on coverage policies.
The new health care laws make it so that your insurance rates cannot be determined by your medical conditions. Only three things can be used to determine rates. Those are age, location and how many people are in your family that require health coverage.
What do you do if you don't have health insurance?
Those who do not have health insurance will either be covered through an expansion in the Medicaid programs or they will be required to purchase health insurance coverage through the health exchange. California's health care exchange is called Covered California. You can learn more about Covered California through their website.
Whether you are covered through Medicaid or have to purchase insurance will be determined on your income. You can find a cost calculator on the Covered California website.
If you don't get health coverage then you may face a penalty. When coverage begins on January 1, 2014, penalties are expected to be fairly lax, but they are expected to be more strictly enforced by 2016. Penalties for children will be half as much as the penalties for adults. The penalties will be charged as follows.
- 2014 annual penalty $95/person with up to a family maximum of $285 or 1% of family income (whichever is greater)
- 2015 annual penalty $325/person with up to a family maximum of $975 or 2% of family income (whichever is greater).
- 2016 annual penalty $695/person with up to a family maximum of $2,085 or 2.5% of family income (whichever is greater).
Penalties will be collected through federal taxes. You can learn more about the penalties on the IRS website.
What do you need to know if you own a small business?
The Small Business Health Options Program (SHOP) is available to small business owners who have 50 or fewer full-time equivalent employees.
SHOP allows for coverage comparisons based on price, coverage and quality.
If your business has more than 50 full-time equivalent employees and you do not offer health coverage you will face penalty fines.
If you are a small business owner who plans on using SHOP, you must offer coverage to all full-time equivalent employees. If you have fewer than 25 full-time equivalent employees you may qulaify for employer health care tax credits.
There are several personal exemptions (which make you exempt from coverage and penalties). You are exempt if:
What if you are self-employed?
If you are self-employed then you cannot get health coverage through SHOP, but you can purchase individual coverage through the exchange.
What do you need to know if you are a college student?
The Affordable Care Act prohibits campus health insurance programs from ending coverage or denying coverage based on pre-existng conditions.
If you are on a school health plan and undergo a major medical emergency the costs will be covered.
If you are not covered under your parents or through your university, then you can obtain health coverage through the health exchange. In California, you can browse coverage options through coveredca.com.
If you cannot afford insurance and your income is below the poverty level, then you may qualify for Medicaid.
If you are younger than 30 years of age, most states offer what is called catastrophic coverage. This type of health coverage usually has very low premiums, but cover you in case of emergency. They usually have a deductibe of several thousand dollars before the coverage kicks in.
If you don't obtain coverage, you will face penalties.
What if you are retired?
If you are retired and over the age of 65 then you probably qualify for Medicare. Medicare now covers more prventive care services.
What if you have a low income?
You may qulaify for lower costs on monthly premiums when you enroll. You may also qualify for lower out-of-pocket costs for co-payments, co-insurances and co-deductibles.
When you fill out your Health Insurance Marketplace application, you'll find out how much you can save. Most people who apply will qualify for lower costs of some kind.
You are exempt from the health insurance coverage requirement and penalties if you can't afford coverage because the minimum amount you must pay for the premiums is more than 8 percent of your household income.