The political debate surrounding the Affordable Care Act (ACA ) has created a cloud of confusion for many people. Here are the key points to offer clarity about how the national mandate will affect North Carolina families.
If you have health insurance…
- You cannot be denied. Your insurer cannot arbitrarily deny coverage for a treatment. New assistance is available to appeal claim denials. Your insurance company can’t drop you over application errors.
- Prevention is provided without copays. Many preventive services, such as cholesterol, diabetes and osteoporosis screenings, as well as many immunizations, must now be offered to you without copays.
- Your kids can stay on. Families also benefit from extended coverage for their young adult children up to age 26.
- Your plan may be extended. Early retirees are benefiting from the extension of their employer-based health care. The Early Retiree Reinsurance Program keeps coverage in place for these people ages 55 to 65 until the federal government implements its Health Insurance Marketplace. (More about that below.)
If you have Medicare…
- You may qualify for a drug discount. Medicare Part D beneficiaries now have access to a 50-percent discount on covered brand-name drugs. The discount is available when you reach the coverage gap known as the “Donut Hole” in your Medicare plan.
If you do not have health insurance…
- You will have more options. You cannot be denied coverage or charged a higher premium due to an illness or disability. Shop for private insurance through the North Carolina Department of Insurance at ncdoi.com. The state’s Health Insurance Smart Program offers assistance with purchasing affordable health insurance. Call 877-855-0231.
- Starting in October 2013, the federal government will offer information about health coverage, some low-cost and even free, through its new Health Insurance Marketplace. You will be able to enroll online or through a toll-free phone number. Coverage from the Marketplace begins in January 2014.
Learn more about healthcare reform in the latest issue of Your Health, Durham Regional’s health and wellness publication for the community.