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