In early December, the Wisconsin State Legislature will be entering a special session that could change BadgerCare and Health Insurance Exchange deadlines for low income individuals and families. If you have questions about how this may affect you, call the United Way of Dane County at 2-1-1. Please check back soon for more information.
What is Health Care Reform?
The Affordable Care Act, also known as Health Care Reform and Obamacare, is a law passed in 2010 to give everyone better access to affordable health care and low-cost insurance. It includes major changes in how health care is provided and what insurance covers.
There are almost 100 provisions in the Health Reform law and many of them have already taken effect. You may have already noticed many of them when you visited your doctor for preventive care and didn’t have to pay a co-pay. Here are a few other big changes that have already happened.
1. Lifetime Cap. There is no longer a lifetime cap on how much an insurance company will pay for if you get sick, and your coverage cannot be canceled for making a mistake on your paperwork.
2. Insurance Company Spending. Insurance companies must spend at least 80 cent of every premium dollar on your health care or improvement to care. Those who do not must issue rebates to members. Insurance companies who want to raise premiums by 10 percent or more must justify the change and receive approval.
3. Young Adult Coverage. Young adults can stay on their parents health insurance until age 26, even if they are not in school, not living with their parents or not financially dependent on their parents.
4. Pre-Existing Conditions. Insurance coverage cannot be denied to anyone under the age of 19 because of a pre-existing condition, like asthma or diabetes.
5. Donut Hole Coverage. Seniors in the ‘donut hole’ of prescription drug coverage receive a 50 percent discount on brand-name prescription drugs covered by Medicare Part D.
6. Preventive Services. Preventive services must be covered without copay or deductible. See a full list here.
What is still coming?
Some major changes are still on the way for health reform. Starting in 2014, lifetime limits on insurance coverage will no longer be allowed, women cannot be charged more than men simply based on their gender and coverage cannot be denied for anyone with a pre-existing condition.
One of the biggest changes coming is the health insurance mandate, a requirement that all American citizens and legal residents have health insurance. In 2015, all large employers will have to offer it to their employees, but until then, you will need to make sure you’re covered. Whether it’s through your employer, your partner’s employer, Medicaid, Medicare or a plan you purchase on your own, everyone will be required to have health insurance coverage in 2014 or pay a fee.
As of October 1, 2013, people are able to shop for plans on the Health Insurance Exchange. The Exchange, also called the Marketplace, is a new way to find health insurance choices and find out if you can get help paying for insurance. You can find it at www.Healthcare.gov. "