ObamaCare and You: What you need to do NOW. ~ Part I

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So we’re hearing alot about ObamaCare this and ObamaCare that. First of all, ObamaCare is the nickname of the Affordable Care Act. But throughout this article and other articles associated with this series, I will only use the term ObamaCare. I will attempt to give you the quick and dirty version of what you should be doing beginning October 1st of this year to be covered by a health plan starting January 1, 2014.

The first time I heard Open Enrollment many years ago, I wondered what that meant. Open Enrollment is the time frame during which you can enroll in a health plan, without a penalty. If you try to enroll after Open Enrollment, you may be charged a penalty fee. So, it is important to enroll within the time frame of Open Enrollment so you don’t incur any penalty fees. We all want to keep that extra change in our pocket, eh? You will begin hearing that Open Enrollment for ObamaCare, begins on October 1, 2013 and will last for 6 months. Do not wait until the last minute, or you may end up having to purchase just any health plan without having time to research what’s good and bad about it.

So, what does ObamaCare mean to you? It means that beginning October 1st, you will be able to go on www.HealthCare.gov to purchase affordable health insurance. This does not mean that you go online and put your information in and automatically have health insurance. No, no, noooo. You actually have to sit down and figure out which health insurance plan you want:

  • Do you want an insurance plan where you pay only a little per month, and if you have to go to the doctor, you have to pay a higher co-pay?
  • Or do you want to pay a bit more per month, so that you can pay a lower co-pay when you go to the doctor?

There are key decisions that you have to make about your health insurance to make sure that you have everything covered, depending on your situation. If you’re wondering what a co-pay is, a co-pay is a dollar amount you pay out of your own pocket when you see the doctor or pick up a prescription from the pharmacy. The dollar amount you pay usually doesn’t change, but there may be instances where you have to pay a different price for a service. For example, you may pay $5.00 for each generic prescription. But when a brand name prescription does not come in the generic form, you may have to pay $15.00 for that brand name prescription. See the difference? The health plan picks up the rest of the bill in both examples.

Let’s talk about what these insurances have to cover. You don’t have to worry about checking to see if the following services are covered, because the federal government told all of these insurance plans that they have to cover these list of services before they can be part of ObamaCare. But remember, the services may require a co-pay to be paid at the time of service. The amount you pay for the service depends on which health plan you pick. This is why it is important not to wait until the last minute to purchase your health insurance. You need time to weigh your options. Below is a list of what the insurance companies are required to cover:

  • Office visits, Lab visits, X-Rays, monthly check-ups for newborns
  • Emergency Room visits
  • Hospital Admissions
  • Mental health and substance abuse treatment
  • Medication
  • Physical Therapy/Rehabilitation
  • Preventative care (regular screenings, such as blood pressure, cholesterol and diabetes; mammograms; prostate; colonoscopy)
  • Dental and vision for children

I have visited the www.HealthCare.gov website and I like the fact that it is pretty user-friendly. How will we get our older folks signed up for this new health insurance? Health insurance itself is a confusing concept for the young, so you can only imagine how daunting the task is for our elders. Make sure you find out where the closest senior citizen center is to your older individual’s homes. Some senior citizen centers are partially federally-funded and offer information sessions to our older individuals about government programs such as Medicare and how this new health plan can supplement the coverage they already have. And you can also help them by registering them on-line.

Certain states have already set up a website for their residents such as the following states:

California residents can purchase their health plan through  www.coveredca.com

New York residents can purchase their health plan through http://healthbenefitexchange.ny.gov

Illinois residents have to purchase their health insurance from the general www.HealthCare.gov website.

My suggestion for you is to go on the website now to familiarize yourself on how to navigate through it. I must warn you that there is a ton of information on these websites, but I am a fan of the fact that it is detailed. If I did not list the state that you live in above, you can find out where you need to purchase your health insurance by clicking the link below to choose your state:

https://www.healthcare.gov/what-is-the-marketplace-in-my-state/#state=alabama

**This article is the first of a series of articles that I will be presenting to you on ObamaCare because this is such a new concept for the federal government. I am sure changes will occur in the near future and no one really knows what to expect yet. I will make sure I unleash any new information to you, my fellow Belizeans, so stay tuned.

Obtained from www.HealthCare.gov website~Accessed September 15, 2013

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