Health insurance protection is a must for growing families. And yet some parents have had a hard time getting - or maintaining - coverage.
Perhaps it’s not offered at your job. Or you lost insurance after being downsized, and buying a private policy is just too expensive. Some have been unable to get coverage for a family member with an ongoing health problem.
While the cost of private insurance may seem pricey, paying for medical bills on your own is even more of a strain. Everyone needs a doctor at some time, whether it’s for a child with strep throat, a spouse with back pain, or a baby is on the way.#1 Way the Affordable Care Act Affects You
With the the Affordable Care Act law, things are changing. Most U.S. citizens are required to have coverage unless they are exempt for specific reasons, such as religious beliefs that bar them from using health insurance benefits, or those with a family income so low that they’re not required to file a tax return. Those who choose to go without insurance may face a tax penalty that starts at 1% of income (or $95, whichever is greater) for the 2014 tax year, and go up to 2.5% of income (or $695, whichever is greater) by 2016. Many who require coverage are, understandably, worried about how they’ll fit insurance payments into their budget. The law has provisions to offset the cost for folks who may need help, along with a few other consumer protections.Benefits
Insurers must pick up the cost of in-network preventive care for kids and adolescents – including annual medical checkups, pediatric vision screenings and immunizations. That means that when your kids need a physical or vaccinations before school starts, you can take them to the doctor with no out-of-pocket spending. In addition, children with health problems can’t be denied coverage, nor can your premiums be higher because of their illness.
Other provisions of the law: Once kids turn 19, you have the option of keeping them on your insurance plan until they reach age 26. Parents no longer need to worry what would happen if their uninsured adult child gets sick or injured.
Adults get preventive services, too: Insurers must provide adults with screenings for blood pressure, cholesterol, and other conditions. And women can see their doctor for an annual check-up and preventive screenings, such as mammograms, without owing a co-pay or meeting a deductible.
There’s a slew of other changes that affect your health plan: Insurers can no longer put lifetime limits on the dollar amount of your healthcare expenses they’ll cover. Annual limits have also been phased out. This is important for families facing sky-high medical bills when a child requires treatment for a long-term condition such as cystic fibrosis.
More big changes happened in January 2014. No one (including adults) who applies for insurance can be turned down – pre-existing condition exclusions are a thing of the past. Plans must now include a minimum level of “essential benefits” – including preventive and wellness visits, lab services, prescription drugs, mental health treatment, hospitalization and maternity and newborn care. Given such coverage, parents don’t need to sweat it financially when the baby needs a round of antibiotics or your spouse’s doctor orders blood tests. However, the additional benefits mean plans have somewhat higher premiums than the plans of the past.Managing the Cost
If you don’t have coverage, you’ll need to shop for a policy. One way is to use one of the online Health Insurance Marketplaces. They’re designed to be a one-stop shop for comparing plans and prices from a variety of health insurance companies like Humana. You can still buy directly from an insurer’s website, or you may want to ask an insurance agent for assistance.
Understandably, many folks are worried about the price tag on health insurance. The law includes a few rules intended to make costs more manageable for individuals and families that meet certain criteria.
On January 1, 2014, government subsidies kicked in. If you purchase insurance using the online Marketplace and you meet certain income requirements, your family could get help paying your premium with a monthly tax credit and your deductible or co-pays may be lowered. Or your family may be eligible for Medicaid or CHIP (Children’s Health Insurance Program), which covers children in families who don’t qualify for Medicaid. Visit InsureKidsNow.gov for more information.
Budgeting for medical expenses is only one of many important financial aspects of raising kids. These rules not only offer more coverage, they make insurance more accessible for families like yours – so you can choose the coverage that’s right for you and your family.
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This information is only a high-level summary of certain provisions of the health care law. This information does NOT attempt to summarize all provisions of the health care reform law. This information is not and should NOT be used as legal or tax advice; it should not be used as a basis for decisions regarding how the health care reform law will affect you and/or your business. Should you have any questions on how the health care reform law (including the high level summary of certain provisions of health care reform) will affect you and/or your business, you should seek professional advice from attorneys or other advisors.
Insured by Humana Insurance Company, Humana Health Plan, Inc., Humana Health Insurance Company of Florida, Inc., or Humana Health Benefit Plan of Louisiana, Inc. or offered by Humana Medical Plan Inc., Humana Employers Health Plan of Georgia, Inc., or Humana Health Plan of Texas, Inc.
For Arizona residents: Insured by Humana Insurance Company. For Texas residents: Insured by Humana Insurance Company or offered by Humana Health Plan of Texas, Inc.
Our health benefit plans have exclusions and limitations and terms under which the coverage may be continued in force or discontinued. For costs and complete details of the coverage, call or write your Humana insurance agent or broker.