Healthcare Reform Questions & Answers

November 9, 2013


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Healthcare reform has created so many questions we thought it would be a good idea to address these to help you more effectively determine your health care choices Safe Harbor is here to help you manage all your choices.

Are the State Exchanges the same as Obama Care?

The State Exchanges are a place to obtain coverage under federal Patient Protection and Affordable Care Act (Obama Care). This is an online market place for shopping and selecting your healthcare plan. Agents and brokers can help you through the process at no additional cost to you. The exchanges are not the actual law, but rather the tool to carry out the PPAC or Obama Care.

When can I start to enroll?

You can begin enrollment on Oct. 1, 2013, for coverage that will take effect Jan. 1, 2014. The open-enrollment period for coverage during 2014, runs from Oct. 1, 2013 to March 31, 2014. There have been system issues that may slow down the enrollment process.

Can I select insurance outside the Exchanges?

Yes, contact our office for help with options both inside the Exchanges and through other markets. Safe Harbor Insurance can offer other options for you. 

If I currently have health insurance, how will reform affect me?

If you have coverage through your employer now, you may not be affected. The legislation is intended (not guaranteed) to preserve the existing employer-based insurance system.  Only small businesses and people who aren’t covered through their jobs will be allowed to buy plans on the new exchange.

Will my healthcare costs go up?

Yes, most likely everyone’s premiums will be going up. Part of the reform provides tax credits, and this will be passed on to those who qualify. In addition, there are changes in all benefit plans (no more pre-existing conditions limitations) and these will increase costs.

Does health reform change Medicaid?

Health reform does not change your Medicaid or Family Health Plus coverage or benefits. This might change in the future.

Are the plans and benefits the same for the Exchanges and other markets?

Not necessarily. All Marketplace health plans are required to cover the ten categories of essential health benefits. However, insurers in many states will have flexibility to modify coverage for some of the specific services within each category.

What are differences in “Gold, Silver, and Bronze” plans?

Plans in the Marketplace are separated into categories — Bronze, Silver, Gold, or Platinum based on the amount of cost sharing they require. Bronze plans will have the highest deductibles and other cost sharing. Gold plans will in general have lower deductible and greater cost. In general, plans with lower cost sharing will have higher premiums. We can help you understand all the options. Here are the plan types with expected cost sharing.

Plan Type       Expected Cost Share

Bronze                         40%

Silver                           30%

Gold                            20%

Platinum                      10%