(by Phil Galewitz; Celebrity Interviews & Gossip, September 24, 2013)
You've heard people arguing about Obamacare (officially known as The Affordable Care Act or ACA) for months... but you may have tuned it all out, because it’s all so confusing and you don’t even know how—or if—it affects you. But starting in 2014, the law will require most people to buy insurance or risk paying a $95 fine, so now’s the time to pay attention. And the fact is, you may discover that there are lots of benefits you’ll be able to take advantage of that you couldn’t before. Here's a quick list of what’s great about the ACA, especially for young women:
1. You can stay on your parents’ health policy until you turn 26. Previously, most insurers did not allow young adults beyond age 21 to stay on their parents’ policies. More than 3 million young adults have gained coverage since this provision went into effect in 2010. Your parents will be charged the same rates as when you were younger. You can be covered by their policy even if you’re married, but the coverage won’t extend to your spouse.
2. You’re entitled to free preventive care, including birth control. Since 2012, nearly 30 million women have benefitted from free preventive services including checkups, screenings for diabetes and HIV, contraceptives and family planning counseling. The law requires plans to cover all FDA-approved birth control methods without co-pays. This includes pills, the Ring, the Patch, injectables (the Shot), implants, intrauterine devices (IUDs), and sterilization procedures. Plans must cover without cost sharing all brand name contraceptives without generic equivalents or where the generic equivalent is medically inappropriate for a woman. Also, certain religious employers are exempt from the birth control requirement.
3. You may be eligible for government discounts on insurance. Starting October 1, new online health insurance exchanges will go live in every state, selling coverage that will take effect January 1, 2014. The exchanges will allow you to compare prices and benefits to find an insurance plan you can afford that fits your needs; if you still feel you can’t afford it, you can find out whether you’re entitled to a federal tax credit based on your income. The lower your income, the higher the tax credit. You can get the discount at the time you enroll. Find information on your state exchange here.
4. You’ll have maternity coverage, no matter what. You may not know this but only about 12 percent of health plans sold on the individual market currently include coverage for maternity, according to Judy Waxman of the National Women’s Law Center. But starting next year, all individual health plans will have to include 10 essential health benefits including maternity care, as well as hospitalization, prescription drugs, mental health services and preventive services.
5. You can’t be charged more than a guy. In most states, insurers are currently allowed to charge women more than men for individual coverage. According to the National Women’s Law Center, in 30 percent of cases, nonsmoking women were charged more than men who smoked. Such gender rating will be outlawed starting next year.
6. You can’t be rejected for having a “pre-existing condition.” Today, insurers can deny you health insurance if you have a chronic condition such as asthma or diabetes (in which case you’re considered a health risk); if they do accept you regardless of these conditions, they can still charge you more for coverage. But starting next year it will be illegal for them to penalize you this way; health premiums may vary based on three factors only: age, where you live, and whether you’re a smoker.
7. If you are an individual who makes under $16,000 a year, you may be eligible for Medicaid. Medicaid is the state-federal health insurance program for the poor, and it’s being expanded by the law to those whose annual income is under the federal poverty level. However, because the Supreme Court ruled that the expansion is optional for states, only about half of them are participating. Check out this infographic to see if yours is one of them.
8. If you’re a breastfeeding mom, you can pump at work more comfortably. Since 2011, the law has required employers to provide a “reasonable break time” and a private place (not a bathroom) for you to pump breast milk during the workday. The law also requires health plans to cover the costs of breastfeeding equipment and breastfeeding counseling without a copay. One final note: not everyone will see immediate coverage changes; many of you who get your insurance through your job are in “grandfathered” plans, which are exempt from some of the rules. Ask your company’s health benefits administrator if this is the case for you.
Correction: This post has been updated to specify which forms of birth control Obamacare will cover without co-pays.
Phil Galewitz is a senior correspondent for Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization. It is not affiliated with Kaiser Permanente.
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Posted By: agnes levine
Saturday, September 28th 2013 at 1:26PM
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