health care reform: understanding your new healthcare options what do i need to know? presented by:...
TRANSCRIPT
Health Care Reform: Understanding your new healthcare options
What do I need to know?
Presented by: Michigan Consumers for Healthcare
www.healthreformtruth.com
So what’s a marketplace?
Essential Health Benefits Coverage
Preventive care
Hospitals
Physicians
Prescription drugs
Mental health
Rehabilitation
Habilitation services
Substance abuse
Dental and vision care for children
Maternity care
www.healthreformtruth.com
What’s the deal with the metals?
• Insurance companies won’t be able to turn people down because of pre-existing conditions.
• This took effect in 2010 for children and on Jan. 1, 2014 for everyone.
Security and Control
www.healthreformtruth.com
• No annual or lifetime limits• Spending caps will limit the amount
consumers pay out of pocket each year.
• Insurance companies have to spend at
least 80-85% of premiums on medical care.
• Eligible for tax credits• Insurers must justify premium
increases
Financial Protections
www.healthreformtruth.com
• Insurance companies will no longer be able to deny coverage due to a pre-existing condition such as: –Breast or cervical cancer–Pregnancy or C-section–Domestic abuse
• An insurer will no longer be able to charge women more than men for the same coverage.
Women
www.healthreformtruth.com
New Insurance Plans Must Cover Expanded Benefits for Women
• Contraceptives and contraceptive counseling is covered with no copay or deductible
• Every dollar spent in pregnancy prevention saves $4 in health costs to mom and child
•HIV screening and counseling •An annual well-woman visit •Breastfeeding support, supplies, and counseling •Domestic violence screening
• Families and individuals will receive tax credits to help pay for health insurance, depending upon income.
• Tax credits will be available to families earning between 133-400% of the Federal Poverty Level (between $31,322 and $94,200 for a family of four).
• Tax credits are designed to keep premium costs between 2%-8% of income, on a sliding scale.
Moderate-Income Americans
www.healthreformtruth.com
Cost-Sharing Subsidies Also Help
• State health insurance programs under Medicaid will cover all families and individuals with incomes up to 133% of the Federal Poverty Level ($15,282 for an individual, $31,322 for a family of four)
• In Michigan, the expanded Medicaid program will not begin until April 1, 2014
Expand State Health Insurance Programs
www.healthreformtruth.com
Eligibility remains the same for infants, kids and pregnant women
• Infants (under 1): Medicaid eligible up to 185% FPL. MiChild 200%
• Children: 150% FPL. MiChild 200%
• Pregnant Women: 185% FPL
• No mandate on small businesses• Rewards good actors with subsidies• Small businesses and non-profits qualify• Single form to fill out• Credits carry over up to 20 years• Maximum subsidy is 50% for smaller businesses
Small Business Benefits Too
www.healthreformtruth.com
Navigators can help answer your questions
What You Can Do
Join MCH’s email list, find us on Twitter @MIChealthcare or http://Facebook.com/consumersforhealthcare
Use the Legislative Action Center at www.consumersforhealthcare.org
Find a navigator near you atwww.enrollmichigan.com
www.healthreformtruth.com