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Health Care Reform

Health Care Reform

The Affordable Care Act (aka ObamaCare) has been part of our lives since 2014.

Thank goodness The Insurance Mom is here to help you understand and use it! For the Top Ten Things To Know go here.

The ACA is basically about two things: 1) accessibility and 2) affordability.

Accessibility simply means that health insurance is available to anyone, regardless of prior health problems (pre-existing conditions). The insurance companies are not allowed to ask you about that embarrassing thing that happened to you in college!

Affordability means that some people can get financial help from the federal government – a subsidy – to help pay the premium.   Prices are based only on your age, zip code and the plan you choose, not your health history.

How much help you get from the feds will be based on your household adjusted gross income (AGI). If your income is really low then you might qualify for Medicaid (in California, it’s Medi-Cal).

Where you can buy health insurance varies… either directly with an insurance company or on your state’s exchange. In California, our exchange is called Covered California.

But you will only get federal help to pay for your insurance if you buy your coverage in your state’s exchange. If you don’t qualify for a subsidy, there is no need to buy insurance on your state’s exchange.

If your employer provides group benefits, your employer could also go to the exchange for small group plans, designed for businesses with under 50 employees. However, there is no requirement for small employers to provide any insurance at all. Large employers (those with over 50 employees) must comply with the ACA.

(No matter what, be sure you have a fabulous broker to help you… don’t do this by yourself!)

But what if you don’t want it health insurance, you ask?

Well… that would just be silly. Let’s remember the premise behind insurance. It is a money management tool, that’s all. Insurance – even your car insurance – is designed to protect you, my dear, against unmanageable, unforeseeable expenses.

Some states still charge you a tax penalty if you don’t have health insurance.  So why put your bank account at risk and have to pay your state more money when buying health insurance would be the grown-up thing to do.

It’s easy if you have a well-educated advocate on your side. So, don’t be stubborn, contact your Insurance Mom, I’m here to help.