Are you one of millions of frustrated Americans who were told they did not qualify for traditional major medical insurance because of a “high-risk” pre-existing health condition? Well as of Jan. 1, 2014, you can no longer be declined if you had/have Diabetes, Cancer, Heart Disease, Rheumatoid Arthritis, Alzheimer’s Disease, or any other serious health problem. Additionally, new individual health plans will also provide benefits for Maternity. (Maternity is not currently covered on individual health plans!)
On October 1st, you will be able to choose from a variety of affordable health plans, regardless of your health! That’s right, “Open Enrollment” through the Health Insurance Exchange program will begin on that date, and coverage for those health plans will become effective Jan. 1, 2014.
The determination of rates for these new “Qualified Health Plans” (or QHP’s) will only consider the following criteria: age, geographic location, single/family status, and tobacco use. No exclusion riders or additional rate-ups can be imposed due to a person’s build (height/weight ratio), gender, prescription drug use, or health issues!
The Affordable Car Act requires these new QHP’s to be offered with several different deductible levels and coinsurance choices. These non-grandfathered plans are required to provide a minimum of 10 Essential Health Benefits (or EHB’s). You can refer to this list of EHB’s by visiting this link on the cms.gov web site: http://www.cms.gov/CCIIO/Resources/Data-Resources/ehb.html . No “lifetime dollar-limits” or “annual dollar-limits” of benefits will be permitted as of Jan. 1, 2014.
Applicants for these certified QHP’s through The Exchange may qualify for a premium tax credit. Subsidies will also be available through a cost-sharing provision. Individual/family household income will be considered for eligibility for these two types of assistance. Eligibility for these premium-savings options will automatically be determined during the application process.
There will continue to be individual/family major medical insurance offered “Off-Exchange”, for those who do not choose an “On-Exchange” QHP, or employer-sponsored group insurance. The new “Off-Exchange” plans must also provide the required minimum EHB’s, and accept ALL applicants regardless of health conditions, Rx use, gender, or build.
We can help you compare your benefits on your current health plan, and offer our insight and suggestions for your 2014 coverage options. For additional details or for answers to your questions, contact a certified Exchange agent at AustinHealthPlans.com by calling: (512) 535-3556 or e-mail at: firstname.lastname@example.org.