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STAY
INFO
RMED
!
WHAT YOU NEED TO KNOW ABOUT
HEALTH CARE REFORM
May 2012
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PROBLEM:Health
Insurance Costs Are TOO
High!
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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?
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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
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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
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EXPANDS CAREBy 2014, all pre-existing
Conditions, lifetime
Coverage caps and annual
Limits are banned
Dependent coverage is extended to age 2626
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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
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WHAT
’S C
OVERED?
MammogramsVis ion CarePregnancy
Annual Wel lness Vis i tsBreastfeeding Support
ColonoscopiesVaccinat ions
Newborn CareMental Health Services
Substance Abuse Services
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Health Exchange = New Market to Buy Insurance!
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HOW CAN I GET HEALTH INSURANCE?
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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