Despite all the controversy it has generated in its ten years of existence, Obamacare still exists, and there is a good reason to expect it will be with us for many years to come in some form. Obamacare is something that has changed the complexion of health insurance in the United States.
Providing Health Coverage For Anyone
There was an important reason for the legislation being called the Affordable Care Act (this is what authorized Obamacare in the first place). It was difficult for people living at or below the poverty line to get affordable insurance that would cover medical expenses. It was also challenging to get the right coverage if a person had a pre-existing condition. Pre-existing conditions no longer prevent someone from having health insurance. Moreover, children may stay on their parent’s medical insurance until they reach 26 years of age. The result is that millions of people who had little or no medical protection at all are able to receive it.
Medicaid is a government program that helps poor people get medical care. Medicaid is now available to those who earn up to 138% of the federal poverty level. States select whether to expand their Medicaid and several have chosen not to do that.
Essential Services Are Provided
Insurance companies that want to have their insurance policies included in the health insurance exchanges set up by Obamacare plans must provide these following essential services:
- Preventive and wellness visits that include chronic disease management
- Maternity and newborn care.
- Medical and behavioral health treatment.
- Laboratory tests.
- Devices and services that help people who have disabilities, injuries, or chronic conditions.
- Prescription drugs.
- Pediatric care.
- Emergency room services.
- Outpatient care.
Obamacare Enrollment Periods
The federal exchange has set periods of enrollment for Obamacare insurance and open enrollment takes place in the fourth quarter of the calendar year. People who want to enroll in Obamacare would do so on HealthCare.gov. Those who fail to enroll will have to find other means of insurance for the coming year. These can be short term policies or an employer-sponsored health plan.
There are special enrollment considerations. People who have experienced a significant change in life, such as the birth of a child or a divorce, may be able to enroll for Obamacare coverage. States that have their own exchanges will also determine enrollment periods. Many follow the federal exchange timetable, but there are some states that have full control of their enrollment inside their borders and state enrollments may extend into the following year. Special considerations, such as the coronavirus pandemic, resulted in some states authorizing a special enrollment period to respond to the crisis.
There Is A Lot to Know
Obamacare is supposed to help people get health insurance. Unfortunately, there are still millions of people who do not have adequate medical protection. One reason is that there is so much a person needs to know. Enrollment periods, eligibility for subsidies, and even what is covered are issues that frustrate many people. They simply give up because it is all too complicated. They could use a little professional guidance and assistance.
We would like to help you.
We are insurance professionals who deal with Obamacare and the health insurance exchanges on a routine basis. We can assist you in understanding all the rules and regulations and help you in deciding what health plan is best for you. We will advise, but we will not pressure you to purchase any given policy. We provide a service, and we work to benefit you.