Q: What is the Affordable Care Act or Obama Care and why should I care?
A: A comprehensive health reform, the Patient Protection and Affordable Care Act (ACA) was signed into law by President Obama in March 2010. The law makes preventive care including family planning and related services—more accessible and affordable for many Americans. It is the largest social program since Medicare and Medicaid. The individual mandate penalty will be enforced via 1040 tax reporting. Everyone should be proactive in avoiding penalties or taking the penalties, minimizing tax liability, planning for the tax credit, and know how all this works.

Q: What is the Affordable Care Act or Obama Care and why should I care?
A: A comprehensive health reform, the Patient Protection and Affordable Care Act (ACA) was signed into law by President Obama in March 2010. The law makes preventive care including family planning and related services—more accessible and affordable for many Americans. It is the largest social program since Medicare and Medicaid. The individual mandate penalty will be enforced via 1040 tax reporting. Everyone should be proactive in avoiding penalties or taking the penalties, minimizing tax liability, planning for the tax credit, and know how all this works.

Q: Where can I get health insurance?
A: These are some healthcare insurance options. Insurance will be offered by: 1. Employers;2. The Marketplace (Exchanges); and 3. Public programs like Medicare and Medicaid.

Q: Does the ACA impact me if I already have insurance coverage?
A: You will not be impacted by the ACA directly if you already have insurance coverage that meets the essential benefits requirements.
• There are special rules for grandfathered and self- insured
plans.
• Standalone plans not covered include long-term care, nursing home assistance, home health care and disability.
• Standalone Medicare supplemental insurance (Medigap) is generally not covered.

Q: What are the deciding factors that determine my health insurance premium costs?
A: The insurance price is determined by only four criteria:
1. Age – Older people won’t pay more than three times the amount younger people pay.
2. Premium Rating Area-High cost areas will have more expensive insurance.
3. Number of family members covered.
4. Tobacco use.

Q: Is help is available to me if I can’t afford to pay for the insurance premium?
A: Yes, Advance Premium Tax Credit (APTC) can be received monthly in advance to pay for the health insurance premium.

Q: Am I going to receive a check from the government directly so I can pay the insurance company?
A: No. APTC will be paid to the insurance company directly to reduce your out-of-pocket premium payment.

Q: How can I obtain the APTC?
A: You must enroll in insurance coverage through Marketplace.
• Young adults and men may see an increase in premiums.
• The government is creating a computer network to verify income and citizenship for purposes of the Premium Assistance Credit. Each state will be allowed to exchange data with the IRS, HHS, SSA and other agencies.

Q: When will the Afordable Care Act be enforced? When can I enroll?

A: On October 1, 2013 the exchanges are open for enrollment for 2014 insurance plans.

Q: If I miss the enrollment window this year, when can I enroll again?
A: You will have to wait until the start of next year’s open enrollment.

Q: What are the essential healthcare benefits that the insurance must cover?
A: Essential healthcare benefits must provide the following coverage.
1. Ambulatory services
2. Emergency services
3. Hospitalization
4. Maternity and Newborn care
5. Mental health and substance abuse
6. Prescription drugs
7. Rehabilitative services
8. Laboratory services
9. Pediatric services including oral and vision care
10. Preventative and wellness services and chronic disease management

Q: Under the Affordable Care Act, are there any limits for coverage?
A: All required essential benefits must be provided with no annual or lifetime limits.

Q: Are there different choices for health insurance under ACA?
A: Yes, there are four levels of insurance available for your choice:
1. Platinum 90% of Actuarial value
2. Gold 80% of Actuarial value
3. Silver 70% of Actuarial value
4. Bronze 60% of Actuarial value
Actuarial value refers to the percentage of costs expected to be covered by the plan.

Q: What if I don’t have health insurance and I never have to file income tax with the IRS, do I have to worry about fines for not having insurance?
A: No. However, you will remain uninsured.

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