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Obamacare: 10 Facts the Young Invincibles Need to Know

Posted on Jul 31, 2014 9:24:43 AM by healtheo360

The Affordable Care Act, also known as Obamacare, can be overwhelming for anyone looking at the changes that will affect them as healthcare consumers. Looking at the ACA centered website, HealthCare.gov, and the Kaiser Family Foundation’s health reform site, there are an incredible amount of questions that the public have about the new legislation.

 

Obamacare:  10 Facts the Young Invincibles Need to Know

Who Are the Young Invincibles?

The Young Invincibles (YI) make up an enormous portion of healthcare consumers, many of which have the most questions about the ACA. The YIs, originally the name of the national organization, Young Invincibles, refers to youths between 18-34 years old who are affected uniquely by the health reform compared to other age groups.

As up and coming members of the workforce, the Young Invincibles are thrusted into the market of health care and health insurance. The ACA adds plenty more material for them to learn before making a decision on health coverage.

To make the process a little easier, here are

The Top 10 Facts the Young Invincibles Need to Know:

  1. Children are able to stay under their parent’s insurance plan until their turn 26 even if you’re married, in school, living separately from your parents, not financially dependent on them, and eligible to enroll in an employer’s plan.
  2. Marketplace enrollment for 2015 health coverage opens Nov 15, 2014 and closes Feb 15, 2015. Unless you qualify for a special enrollment period, you may not apply for private health insurance through the Marketplace after it closes. The Marketplace offers various grades of health plans from bronze to platinum that may appeal to different kinds of consumers and their budgets.
    1. If not enrolled in a plan for at least 3 months, 1% of your income (if over $19,650) or $95 will be charged in your federal income tax return.
    2. If you earn under $10,150 or have minimal essential coverage (see healthcare.gov), then no fine will be charged.
  3. Preventative care and services such as blood pressure and diabetes tests, birth control, and a number of vaccinations will be covered under most health insurance plans. (Only applies to people enrolled in job-related or individual health plans created after March 23, 2010)
  4. Summary of benefits and coverage and a glossary of terms must be provided by all health insurance issuers and group health plans in “plain language.” They will come in a standard format such as a Nutrition Facts label to allow for easy-to-do comparison shopping.
  5. Insurance companies cannot exclude coverage based on pre-existing conditions for people under 19 years-old and for those who were part of a grandfathered group health plans/insurance. (Does not apply to grandfathered individual plans)
  6. No more lifetime or annual dollar limits on your benefits. Banned in 2010, insurance companies are prohibited to set limits on how much they will spend on your benefits annually and in the lifetime you have been enrolled in their plan.
  7. You will receive rebates on premiums if insurers don’t spend at least 80% of your premium payments on medical care and quality improvement.
  8. Insurance companies cannot cancel your plan for mistakes on forms and ask for their money back. If you put false information or don’t pay premiums on time, then they can rescind your plan with 30 days notice.
  9. YOU can choose a primary care doctor (in-network) and ER service (in and out-of-network). There’s no approval requirement or higher out-of-pocket expenses for ER services outside your health plan’s network. Referrals are also not mandatory for women to see an OB-GYN.
  10. Companies with 50+ full-time employees must pay for insurance or otherwise pay a penalty. Smaller businesses with under 20 employees are not required to provide insurance or pay a penalty, but may receive temporary tax credits to help pay for their employee’s plans.

The ACA doesn’t change much for those who are already insured by job-related health plans or the government, but for the young Americans who are new to acquiring health insurance, these are definitely points to look out for.

Learn more about the ACA and find more answers at healthcare.gov.

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