The New Health Care Law – What It Means for You, and When :: Wamhoff Financial & Accounting

The New Health Care Law – What It Means for You, and When

Health Care Reform was passed nearly three years ago, yet a recent study reported that 57% of Americans do not feel they understand the new health care laws and how they will be impacted. Sandy Furuya, Senior Account Manager for Wamhoff Financial Planning & Accounting, outlines what is in place now and what to expect in the coming months.




In effect now:

·            Medicare funding to states for better access to preventive care at little to no cost. Includes blood pressure, diabetes, many cancer screenings, well baby and child visits, and routine vaccinations

·            Lower out-of-pocket prescription drug costs for seniors. This could mean as much as a 52.5% discount of brand name drugs and 21% on generic. This will gradually decrease by 2020.

·            Measures to strengthen Medicare. Medicare Advantage plans that give better quality care receive bonus payments which must partially be used to offer you additional health benefits.

·            Better measures to reduce waste, fraud and abuse, as well as medical identity theft prevention.

·            Outside, unbiased review when you appeal a claim that’s been denied by your insurance company.

·            Expanded availability of information about nursing homes and long term care facilities. This includes inspections and information about consumer complaints.


October 1, 2013 :

·            Open enrollment in the Health Insurance Marketplace for individuals and small businesses begins.

·            The marketplace is designed to help individuals and small businesses find a plan to fit their budget.

·            It will help those who are uninsured, as well as those looking for new options for their coverage

·   offers checklists for individuals, families and small businesses so they may start preparing now for enrollment once it opens in October.


January, 2014:

·            Establishment of the Health Insurance Marketplace.

·            Insurance companies will no longer be able to deny coverage, or increase rates, for those with pre-existing conditions.

·            Lifetime coverage limits to fixed dollar amounts will end.

·            Tax credits to help lower and moderate income families afford coverage.

·            Tax credits to small businesses and non-profit organizations will increase.

·            Requirement for those who can afford it to obtain basic coverage, or pay a fee. If they show they cannot afford it, an exemption may be possible.


What this all means for you:

·         It is likely that the costs for employer plans will rise, so employers will be reviewing their plans.

·         The days of “Cadillac Plans” are over.

·         Employers may pass on their increased costs to employees, or, change the coverage to keep the same costs.

·         The uninsured will be able to find catastrophic insurance plans.