What is the Affordable Care Act?
The Affordable Care Act is a law that seeks to improve the health and wellbeing of 50 million uninsured Americans by providing access to affordable health insurance that guarantees you get the care you need when you’re sick, covers preventative care to keep you healthy, doesn’t deny access because of pre-existing conditions, and more.
Why did health care need reforming?
Currently uninsured Americans get very little preventive care and only seek health care when their conditions are in advanced stages, which often means going to emergency rooms where care is most expensive. When that happens, everyone with insurance picks up the tab as physicians, hospitals, and other health care providers pass along their unreimbursed costs.
Who benefits, and when?
Beginning January 1, 2014, all Californians will have access to health insurance even if you have a pre-existing condition like insulin dependent diabetes, asthma, cancer or anxiety.
What is the Individual Mandate?
The Affordable Care Act requires everyone to have health insurance by January 1, 2014. Penalties will be applied to your taxes if you do not follow the law.
Get Help Paying Your Premium
There are financial assistance programs to help make the new coverage affordable.
- If your Modified Adjusted Gross Income (MAGI) is below 139% of the Federal Poverty Level (FPL), you will be eligible for Medi-Cal. Visit CoveredCA.com to sign up.
- If your Modified Adjusted Gross Income is between 139% and 400% of the Federal Poverty Level (FPL), you are eligible for tax credits to help pay your monthly insurance premiums. Contact Denise for help in selecting a plan through the California exchange
- If your Modified Adjusted Gross Income is between 139% and 250% of the Federal Poverty Level, Tax Subsidies help you pay the co-pays and co-insurance as you use the plan. Denise can help you determine if you are eligible for subsidies and steer you to the appropriate level of coverage to access this financial support.
- If your income is above 400% of the Federal Poverty Level (FPL), contact Denise for help buying coverage from either inside or outside the California exchange. You will not be eligible for tax credit or subsidies. The extra step of entering your financial information will not benefit you in any way.
What does the Affordable Care Act mean to you?
- Effective January 1, 2014, you cannot be turned down by any insurance company because of a pre-existing condition. Neither can your coverage be dropped because you’ve exceeded the policy limits.
- Your policy will cover ten Essential Benefits
- Ambulatory patient services (services people walk in to receive)
- Emergency Services
- Hospitalization
- Maternity and Newborn Care
- Mental Health and substance use disorder services, including behavioral health
- Prescription Drugs
- Rehabilitative and Habilitative Services and Devices
- Laboratory Services
- Preventive and Wellness services and chronic disease management
- Pediatric services
- Preventive care will be provided without a co-pay or co-insurance (at no cost to you).
What exactly do you have to do to get an Affordable Care Act Health Insurance Plan?
The application process has five Steps. Before you begin, gather your most recent tax return including dependent status information, birthdates and social security numbers for everyone in the home, your home zip code and immigration numbers if applicable.
Step 1: Input information about your household:
- The number of people in your household
- Your household income from your tax return,
- Your zip code
- The ages of everyone in the household
Step 2: See if you are eligible for financial assistance.
Simply click the See My Options button
Step 3: Make a selection from your list of Options
Step 4: Complete the application, being sure to add Denise Lombard as your Broker
Step 5: Pay your share of the first month’s premium
