Obamacare: What you need to know

The federal health reform law commonly known as Obamacare will bring many changes in the coming months.

As of Jan. 1, most people in Connecticut will be required to have health insurance or pay a penalty. More people will be eligible for Medicaid, and there will be a new marketplace to sell insurance to people who don’t get it through their jobs, often at discounted rates. Insurance companies will have to follow new rules, including the requirement that they sell insurance to anyone who wants to buy it, regardless of their medical history.

How all these changes affect you depends on many factors. People who are uninsured or buy insurance on their own are likely to feel the effects of the law the most. Those who get their insurance through jobs, especially workers at large companies, are likely to notice the fewest changes.

The basics

To learn more about what’s happening, who’s required to buy insurance and who’s not, what the new options are for people who need coverage, and more, click here.

What does it mean for you?

See how people are affected: A young single guy, a low-income couple, a woman with a pre-existing condition, a college student, a family with self-employed parents, a family with employer-sponsored coverage, a man with Medicare and his wife without it

The Exchange

The health insurance exchange, known as Access Health CT, is a marketplace for people to buy health insurance, created by the federal health law. It’s intended for people who are currently uninsured, who buy insurance on their own, and for small employers. Many people who buy insurance through the exchange are expected to qualify for discounted premiums, subsidized by the federal government. It opens for enrollment Oct. 1, selling plans that take effect Jan. 1.

For more on what an exchange is, click here.

What do plans sold in the exchange cost? Click here for a list.

People who earn up to 400 percent of the poverty level will be eligible for a discounted insurance premium if they buy coverage through the exchange. The chart below shows what that translates to in dollars.

Obamacare 400 FPL larger

To find out more about what your discount would be, click here.

But it’s about more than cost. The different types of plans vary widely in how much of your medical costs they’ll cover. To learn more, click here. Each insurance company must offer a standard plan design, but can also offer their own, nonstandard options. For a list of each standard plan’s deductibles, copays and coinsurance requirements, click here. You can find the nonstandard plans by searching for coverage through the Access Health website and clicking on the links for detailed plan documents.

What doctors and hospitals will accept insurance sold through the exchange? The insurance companies are providing their own directories. You can find them by clicking on the company name: ConnectiCare HealthyCT Anthem (to find the Anthem exchange plans, go to the “Plan Type/Network” field and select one of the plans marked “Pathway X”). For more on finding the provider lists, click here.

Medicaid

As of Jan. 1, the state will expand Medicaid eligibility for adults who don’t have minor children. This is expected to affect between 55,000 and 60,000 people.

The new income limit will be 138 percent of the poverty level. The chart below shows how that translates into dollars.

Obamacare 138 FPL larger

For more on what Obamacare means for Medicaid, and how things are changing for people currently in the program click here.

 

Q&A

Reader questions, answered

Part 1: What will it cost me? Does it cover dental? What doctors will take it? And what about health savings accounts?

Part 2: What if I’ve been denied coverage in the past? How can I avoid getting penalized for not having insurance if I lose my job? And is free insurance a good deal?

Part 3: What about people with Medicare? How do you determine premium discounts if your income is erratic? And can an employer take advantage of lower individual-market rates to cover his workers?

Have a question you’d like answered? Email Mirror Health Reporter Arielle Levin Becker at alevinbecker@ctmirror.org.

 

Resources

Access Health CT: website Call center: 1-855-805-4325

Connecticut Department of Social Services: website Call center: 1-855-6-CONNECT

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