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Top 10 things to Know About ACA

Top 10 things to Know About ACA

The Obamacare Act consists of more than 900 pages of health care related reforms. This can turn out to be quite overwhelming for the common people. Below is a quick recapitulation of the top 10 important things to know about the Affordable Care Act and to reap in the benefits it provides.

Top 10 ACA Facts:

  1. The law makes it compulsory for everyone to possess minimum essential coverage for at least 9 months in a year. Failing to do so will attract a fine for every uninsured family member. As of 2019 this fee has been removed by the federal government but it continues to be charged in some states. So it is advised that one should always go through the rules of the states before applying for any insurance plan.
  1. The Minimum Essential Coverage as mentioned in the Obamacare Act generally accounts for all forms of health insurance options like Medicare, Medicaid, plans sold inside and outside the marketplace but short term insurance plans are not covered in it. SO always ensure that you are not settling for any short term plans otherwise you will also be liable to pay the fine.
  1. To apply for any plan that is offered in the Marketplace the only time to do so is during the Open Enrollment Period. The dates of the Open Enrollment Period are declared well in advance and generally tend to fall during the months of November and December each year. If someone doesn’t qualify for Special Enrollment or is not covered by any government funded relief programs like Medicare, then this is the only time one can enroll himself and his family.
  1. In case someone has experienced some major life changing situations or is currently undergoing one like moving to different location, going through divorce, planning for a family or has lost his job, then he may qualify for the Special Enrollment option. But his eligibility has to be verified first from the marketplace.
  1. The marketplace not only offers health insurance plans but is also a good platform to compare among the various plans. Generally Obamacare plans come in 4 tiers namely Bronze, Silver, Gold and Platinum, but there are many plans offered by individual insurance companies under these tiers. Apart from this, cost assistance options can also be checked for each of the plans.
  1. If someone meets all the criteria’s for availing Medicaid or CHIP programs then he has the option to enroll anytime during the year and no enrollment period will be liable for him. The main eligibility for qualifying for these relief programs is based on the annual income of the individual.
  1. It is not mandatory to purchase plans only offered in the Marketplace. One can always choose a plan from any private source if it is more suitable to him. The only constraint here is that the plan should meet all the Minimum Essential Coverage criteria’s as mentioned in the ACA.
  1. Perhaps the most important point to remember is that high cost plans prove to be more beneficial for people who often tend to fall sick or require special treatment. If someone barely needs medical care for the whole year then it is best to settle for some low cost plans.
  1. The ACA mandates that every plan should provide the 10 essential medical facilities mentioned in it.
  1. For large employers, it has been mandated to cover the medical expense of at least 50 of their full time employees. For small companies new plans have been introduced via SHOP and handsome tax reliefs are being provided if they choose to cover their employees.

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