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The Most Important Aspects of the Affordable Care Act

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  • What You Should Know About the Affordable Care Act

    What You Should Know About the Affordable Care Act

    The Affordable Care Act was passed in 2010 to help make healthcare more accessible and affordable for the average American. Before the Act, it was possible to be denied health insurance for having a pre-existing condition. You could also be kicked off of an insurance plan for requiring too much care.

    Healthcare reform has helped more than 16 million Americans receive affordable health coverage, according to the White House. Keep reading to learn about the most important aspects of the Affordable Care Act.

  • Essential Health Benefits

    Essential Health Benefits

    Every health plan offered by health insurance companies must include essential health benefits. These benefits include:

    • outpatient hospital services
    • inpatient hospital services
    • emergency services
    • prenatal, maternity, and newborn care
    • pediatric care
    • preventive and wellness services
    • chronic disease management
    • mental health disorder counseling and care
    • substance abuse counseling and treatment
    • prescription drug coverage
    • laboratory tests and services

    Some health insurance plans offer additional benefits.

  • You Can’t Be Denied Coverage

    You Can’t Be Denied Coverage

    Before the Affordable Care Act, a health insurance company could charge more or deny coverage if you had a pre-existing health condition. They could also refuse to treat a pre-existing medical condition. Since January 1, 2014, anyone can now purchase health insurance, regardless of whether they’re sick or were previously denied coverage.

    There is one exception. Individual health plans purchased before March 23, 2010 that had a pre-existing condition rule still don’t have to cover costs related to the illness. These plans are grandfathered in and don’t have to comply with the new law. To get a health plan that covers your pre-existing condition, apply for insurance through the marketplace.

  • Your Insurance Company Can’t Put a Cap on Your Benefits

    Your Insurance Company Can’t Put a Cap on Your Benefits

    As of January 1, 2014, health insurance companies can no longer put an annual cap or limit on essential health benefits. This means you won’t run out of benefits if you become sick or you're diagnosed with a chronic condition.

    There is another exception. Health insurance companies can still cap benefits on individual health insurance plans purchased before 2014. These health insurance plans are also grandfathered in by the new law.

  • What to Do if Your State Doesn’t Have Expanded Medicaid

    What to Do if Your State Doesn’t Have Expanded Medicaid

    The Act provides funding for states to expand their Medicaid programs and offer coverage to more people. Medicaid is a health insurance plan that covers millions of low-income families and individuals. As of 2015, 19 states have chosen not to expand their Medicaid programs, according to the Kaiser Family Foundation.

    You can still apply for health insurance if your state hasn’t expanded its program. You may qualify for tax credits to help pay for coverage. If you qualify for expanded Medicaid, but you live in a state that’s not expanding its program, you may receive an exemption and won’t have to pay the penalty. You have to apply for insurance to get the exemption.

  • What You Need to Apply

    What You Need to Apply

    You’ll need a few documents and information once you’re ready to apply for health insurance or switch your plan. This information helps determine if you’re eligible for a tax credit, a lower-cost premium, or Medicaid. Be prepared to pull the following documents together:

    • basic information about everyone applying for coverage (name, social security number, address, birth date)
    • employer and income information for everyone applying for coverage
    • information on how you file your taxes
    • estimated household income for the year
    • policy numbers for any existing health insurance plans
    • a completed “Employer Coverage Tool” if you have or are eligible for coverage at work
    • information about any plans purchased through the marketplace in the previous year
  • Where to Shop

    Where to Shop

    Begin your search at Healthcare.gov. You’ll be directed to your state’s health insurance exchange if your state has one. If your state doesn’t have its own health insurance exchange, you’ll use a federally operated exchange through Healthcare.gov. You can usually only purchase health insurance during the open enrollment period each year. Medicaid and CHIP (Children’s Health Insurance Program) offer special enrollment periods.

    Create an account on Healthcare.gov, fill out an application, and then compare health plans. Since private insurance companies offer the health insurance plans, you’ll complete your purchase through the insurer’s website.

  • Where to Get Help

    Where to Get Help

    If you have questions about the Affordable Care Act or need help using the website, call customer service at 1-800-318-2596 or chat with a representative on the website. You can also search for organizations providing help in your area at LocalHelp.Healthcare.gov.