the patient protection and affordable care act

THE PATIENT PROTECTION AND AFFORDABLE CARE ACT

Community Health Initiative of Kern County

HAVE YOU HEARD?

Health Care Reform

OBAMACARE

The New Health Law


HAVE YOU HEARD?

The Patient Protection and Affordable Care Act

PATIENT PROTECTIONS


PATIENT PROTECTION1. Cannot be denied coverage due to a pre-

existing condition.2. Able to maintain coverage for young

adults.3. Ends lifetime limits on health coverage.4. Restricts or eliminates annual limits on

coverage5. Provides preventive services at no cost.

Expanded preventive services are offered to women


PATIENT PROTECTION6. Does not allow premium increases without

justification.7. The majority of the expenses must go

towards medical costs.8. Cannot cancel coverage due to errors on

the application.9. Requires an easy to understand explanation

of benefits and coverage.10. Essential benefits AND MORE!

INDIVIDUAL MANDATE


THE INDIVIDUAL MANDATE

Most U.S. citizens and legal residents must have health

insurance or pay a fine.



2014 2015 2016

For every uninsured adult $95 $325 $695

For every uninsured child $47.50 $162.50 $347.50

Or a percentage of your income, whichever is greater

1% 2% 2.5%


THE INDIVIDUAL MANDATEWho is exempt? Persons with a religious objectionUndocumented immigrantsIncarcerated personsMembers of Indian Tribes If your household income is so low that you are not required to file an income tax returnIf buying health insurance is too expensive



There are options!



My employer offers me health insurance.



My employer does NOT offer me health insurance

and My total household income is less

than 138% of the Federal Poverty Level




andMy total household income is less





andMy total household income is more



THE INDIVIDUAL MANDATEWho is exempt? Persons with a religious objectionUndocumented immigrantsIncarcerated personsMembers of Indian Tribes If your household income is so low that you are not required to file an income tax returnIf buying health insurance is too expensive



My employer offers me health insurance.Coverage must be:

1. Affordable2. Adequate



My employer offers me health insurance

butthe coverage is NOT

ADEQUATE.(on average, it pays less than 60% of medical

costs)



My employer offers me health insurance

butthe coverage is NOT

AFFORDABLE.(I have to pay more than 9.5% of my income in

premiums)


THE INDIVIDUAL MANDATEYour options:1. Employer sponsored health insurance2. Medi-Cal3. Covered California with Premium Assistance4. Covered California without Premium

Assistance

Enrollment closes March 31st, 2014


661-632-5018

WE’RE HERE TO HELP!


EXPANDED PREVENTIVE SERVICES FOR WOMEN

Anemia screening Breast Cancer Genetic Test Counseling Breast Cancer Mammography screenings Cervical Cancer screening Contraception Domestic and interpersonal violence screening Gestational diabetes screening HIV screening and counseling Osteoporosis screening Tobacco Use screening and intervention


ESSENTIAL HEALTH BENEFITS

Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use

disorder services including behavioral health treatment

Prescription drugs


ESSENTIAL HEALTH BENEFITS

Rehabilitative and habilitative services and devices

Laboratory services Preventive and wellness services

and chronic disease management Pediatric services including:

Oral Care Vision Care


MEDI-CAL

Family Size Adults(138%)

Children(250%)

1 $15,971 $28,7252 $21,559 $38,7754 $32,582 $58,6007 $47,361 $89,025


COVERED CA WITH PREMIUM ASSISTANCE

Family Size Household Income up to:

1 $45,9602 $62,0404 $94,2007 $142,440


COVERED CA WITHOUT PREMIUM ASSISTANCE

Family Size

Household Income Greater than:

1 $45,9612 $62,0414 $94,2017 $142,441

the patient protection and affordable care act

Documents

employees household

employersponsored coverage

income tax returnif

employer plan

patient protectiondoes

explanation of benefits

tax credit

premium increases