Obamacare is about to take effect. And at this point, whether you think it's an abomination or the best thing since sliced bread, it's time to wade into the waters of the healthcare marketplace or face fines.
Unfortunately, navigating the landscape of the Affordable Care Act is more than a little complicated. There are so many questions, so few answers (and only one marginally functional website). So, to make things easier for artists and other self-employed creative types, we spoke to Sandra Garcia, a Marketplace Certified Agent with Creative Healthcare Marketing on the top ten things to know about healthcare reform.
If you still have questions, Life is Art and the Arts & Business Council are hosting a forum on November 18th to fill in all the blanks.
10. Pre-existing conditions are irrelevant.
Previously, when you were applying for insurance, you were asked a million and one health questions. Now, there are none. Everyone is covered.
9. No more rating, i.e. jacking up individual premiums.
Before, pre-existing conditions meant higher premiums. Now, health status doesn't affect your monthly cost.
8. Males and females will be paying the same rates.
Rates for women have always been higher (mainly because of child-bearing), but no more. It's an even playing field based on age and location.
7. Rates will probably go up for people under 45.
Younger people do have to carry some of the burden of the older, most expensive population. But the good news is, even sicker younger people will be covered.
6. There are subsidies for those with lower incomes.
Based on your financial position relative to the poverty line, you may or may not qualify for help. Click here to check out the 2014 Federal Poverty Levels
5. Maternity/newborn care and mental health/substance abuse services will be covered as of 2014.
In some private plans, these used to be opt-ins that cost extra, or exclusions altogether. Now, they're a standard part of any plan and on the list of the ten "essential benefits" that every plan will cover. The others are hospitalization, emergency treatment, outpatient services, prescription drugs, rehabilitative services, laboratory services, preventative and wellness services and chronic disease management and pediatric services with dental and vision care.
4. Alternative medicine isn't covered.
Way to be progressive, powers that be. Lame. But, "some carriers will offer a small discount through a 3rd party administrator," Garcia says.
3. Smokers will pay more.
While pre-existing conditions aren't a factor, smoking certainly is. Sorry nicotine fiends, you've gotta pay up. Whether or not you smoke is the one and only health question on the Healthcare.gov application.
2. Deductibles are likely to be high.
The new plans come in bronze, silver, gold and platinum, and each cover different percentages of healthcare costs, says Garcia. "Bronze covers 60 percent of expected costs; silver, 70 percent; gold, 80 percent and up to platinum at 90 percent. Bronze plans have the lowest premiums and the highest cost sharing," she explains. But in the end, all plans cover the same benefits and cap annual out-of-pocket expenses at $6,350 for an individual, $12,700 for families.
1. For some people, it might be better to wait to 2014 to opt in.
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"Some people will be better off waiting, especially if they qualify for subsidies, want maternity or mental health," says Garcia. "Others will be better off renewing their existing coverage or purchasing coverage by December to avoid sticker shock, mostly for those who are 40 or younger."
And, if you want to learn more (we're betting you do), you can attend the forum on November 18. It's $10 to attend and it'll feature a series of experts who'll cover all the aspects of the new insurance options and help everyone understand their choices. It runs from 3 to 6 p.m. at HistoryMiamiand you can RSVP online.
Follow Hannah on Twitter @hannahalexs.