stay informed! what you need to know about health care reform may 2012

STAY

INFO

RMED

!

WHAT YOU NEED TO KNOW ABOUT

HEALTH CARE REFORM

May 2012

PROBLEM:Health

Insurance Costs Are TOO

High!

o Lowers the cost of individual & small business health insurance

o Improves the quality of health careo Makes health care more accessible

WHAT DOES THE AFFORDABLE CARE ACT (ACA) DO FOR YOU?

AM I REQUIRED TO HAVE HEALTH INSURANCE?o All individuals MUST be enrolled in a

health insurance plan by 2014 that meets basic minimum standards, as set by the governmento This can include Medicaid

o If you don’t have health insurance, you will have to pay a fee*

*Waivers are available under certain conditions, such as religious beliefs

2014$95/year

2016$695/year

DO YOU QUALIFY?o Lawfully present individuals must

buy health insurance (individual mandate)

o May buy health insurances in state exchanges or qualify for Medicaid

o May qualify for federal assistance if <400 Federal Poverty Level (FPL)o Individual: Annual income <$44,680o Family of Four: Annual income <$92,200

EXPANDS CAREBy 2014, all pre-existing

Conditions, lifetime

Coverage caps and annual

Limits are banned

Dependent coverage is extended to age 2626

BENEFITS FOR WOMEN Ban on lifetime

coverage limits Allow adult

children up to age 26 to join or remain on a parent’s health plan

Phased-in ban on annual limits

Pre-existing ConditionInsurance Plan

Preventive services coverage without copay

$250 rebate for Medicarebeneficiaries in Part D

Phased-in ban on annual limits

Better coverage and lower cost on brand name prescription drugs for Medicare beneficiaries in Part D

Medicaid expansion

State insurance exchanges

Insurance market reforms, including no rating on gender

Premium and cost sharing credits for exchange plans

Employer shared responsibility penalties

2010 2011- 2013 2014

WHAT

’S C

OVERED?

MammogramsVis ion CarePregnancy

Annual Wel lness Vis i tsBreastfeeding Support

ColonoscopiesVaccinat ions

Newborn CareMental Health Services

Substance Abuse Services

Health Exchange = New Market to Buy Insurance!

HOW CAN I GET HEALTH INSURANCE?

NEED MORE INFORMATION?o www.IllinoisHealthMatters.orgo www.HealthCare.govo Asian and Pacific Islander American

Health Forum (http://www.apiahf.org/)o Kaiser Family Foundation

o Implementation Timeline: (http://healthreform.kff.org/timeline.aspx)

o Healthcare Hits Main Street Video http://www.youtube.com/watch?feature=player_embedded&v=3-Ilc5xK2_E