Note: Affordable Care Act enrollment runs from October 15, 2018 to January 15, 2019. AltaMed is ready to walk you through your options for free. Call us today at 877-462-2582.

ACA, Obamacare, the Patient Protection and Affordable Care Act, Healthcare Reform…it’s known by a few different names, but the Affordable Care Act (ACA) is a law passed by President Barrack Obama in 2010. Its basic goals are to help more people get coverage, ensure health plans provide certain essential benefits, and help control costs for everyone.

Since it was passed, the Affordable Care Act has become incredibly popular, but it’s under attack by politicians and interest groups who want to do away with it. There’s been a lot of misinformation spread about it, so we want to give you information about what it is and what it actually does, so you can feel confident when enrolling in a plan and using your benefits.

The Facts:

It provides safeguards for people with preexisting conditions

A preexisting condition is any type of disease or condition that you have before the start date for your new health care plan. For example, asthma, diabetes, thyroid disorders, cancer or even pregnancy have all been considered preexisting conditions.

In the days before the ACA, if you had a preexisting condition, an insurer could refuse to sell you coverage, charge you extremely high prices for a plan, or sell you a plan that did not provide coverage for the care required by your condition. But under the ACA, if you have a preexisting condition, you cannot be denied coverage and you can’t be charged more.

By helping more people get care, it keeps costs down for everyone

Here’s a scenario that was all too true before the ACA: say a person with diabetes had a plan that did not cover their doctor visits or testing supplies. Instead of getting routine care at the doctor’s office, they let their diabetes spin out of control to the point where they had an emergency, then had to be rushed in an ambulance to an emergency room. Now, instead of paying $30 copay, which they would have received had they visited their primary care physician, they may be left with a bill for thousands of dollars. Some of which would have been paid for through their insurance plan; this would end up raising costs for everyone.

But under the ACA, a person with diabetes would get lower cost office visits – and in some cases, they might even get their testing supplies covered for free. They stay healthier and save their plan money.

The ACA provides essential coverage to keep people healthier

The ACA required insurance plans to cover many routine preventive services. Like the example used above, accessing these services early can help people stay healthy and reduce their risks for conditions that require complex medical treatment.

Some of these services include:
 

• Prescription drugs
• Laboratory services
• Mental health and substance use disorder services
• Maternity and newborn care
• Pediatric services

The Myths:

The government decides what treatments you get, and you can be denied a treatment if it’s too expensive

Not true. What treatments you receive are between you and your doctor. Your insurance may decide how much to pay – and in a few very rare cases, they may decide not to cover certain treatments, but you always have the option to still receive that treatment. The government has nothing to do with it.

The government forces people to buy plans

Up until recently, anyone who didn’t purchase coverage was charged a penalty. But starting with coverage year 2019, the penalty no longer applies.

The government does want everyone to purchase a plan. The way insurance works is that it’s a big risk pool – odds are that in large group, there will be some people who are sick and need care, but most people will be healthy. And this only works when everyone, including young, healthy people who don’t need very much care, purchases a plan.

You can only buy a plan on the Covered California website

You can actually buy a plan from any company you like – if you want a specific plan from an insurance company like Aetna or Blue Cross, you can go to a broker and ask for it. You can also get a plan through your employer, if it’s offered.

If you qualify for a subsidy from the state to help you purchase a plan, then you most purchase it through Covered California (also known as “the marketplace”). About 88 percent of those who enroll through Covered California are eligible for a subsidy!

Take Action and Enroll Now

You and your family’s health matters! Take steps now to make sure you’re covered in a plan that fits your needs and your budget. AltaMed can help walk you through your options for free. Call us at 877-462-2582.