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What coverage do you get with obamacare?

Here's what you need to know...
  • All Obamacare Health plans have the Essential Health Benefits
  • Coverage includes pre-existing health and mental health conditions
  • Obamacare offers four types of Plans
  • Marketplace policies must be affordable and cost less than 8 percent of annual income

Obamacare Plans satisfy the Individual Mandate and avoid tax penalties for non-coverage
Obamacare coverage aims to provide essential health benefits that will help detect and treat preventable illnesses. These include annual physical exams, screenings and tests, vaccinations, and lab work to aid diagnosis. The ACA emphasizes preventive medical care and wellness. It is simply far better and less costly to detect and treat diseases before they become severe, and it is better to maintain wellness than to cure disease. Comparison shopping adds a particular focus when searching among Obamacare plans. It focuses on the applicant’s most important needs and helps find the right plan. Start comparing health plans now by using our FREE tool above!

Best Coverage Options

The best combination of Obamacare coverage for the calendar year 2016 is the high deductible Silver Plan. When combined with a Health Savings Account, the plan creates an asset for paying deductibles or for future medical expenses. Seniors do not have to purchase Marketplace plans; they can meet the requirements of the individual mandate through Medicare. The Medicare Plan A and B is the best plan for seniors.

Obamacare reinforced the Medicare program; it added the essential benefits coverage.

The best plan for children of low-income families is the InsureKidsNow.Gov coverage. It is available at any time of year and not limited to Open Enrollment. Low-income individuals and families can get coverage through Medicaid, and most state Medicaid agency coverage meets the requirements of the individual mandate.

Individual Mandate

Obamacare requires every eligible person to get and maintain qualified health coverage. This is by definition coverage that meets the minimum essential coverage standard. Federal rules applicable to insurance providers include minimum essential coverage; insurance providers understand that they must meet or exceed this standard in all of their policies. Programs that meet the requirements of the health care law include the following categories.

  • Employer-sponsored plans including retiree plans and COBRA
  • Medicare Part A
  • Federal Medicaid
  • InsureKidsNow.Gov
  • State Medicaid

Open Enrollment

Beginning November 1, 2015, and running through January 31, 2016,, the public can sign up for qualified health insurance coverage for the calendar year 2016. The public has a right to enroll during this time period. After Open Enrollment, applicants can only enroll if they meet the criteria for special enrollment periods. These include Life Events such as divorce, marriage, childbirth, and losing coverage as a dependent or employee. Open Enrollment is the official period for the below-listed health plan actions.

  • Getting a new policy, new enrollment and policies for new status persons such as dependents past the age of 25
  • Renewing an old policy
  • Changing an existing policy

The Types of Plans

The Obamacare marketplace offers four types of plans based on actuarial value. The ratings assess the percentage of essential benefits paid by the insurance versus the amount paid by the consumer. Called the metal plans, these four categories help consumers compare plans that pay approximately the same amount of benefits. The following items outline the coverage of the four metal plans.

  • Platinum plans provide 90 percent coverage of essential health benefits. These plans have high premiums and low out of pocket costs and deductibles.
  • Gold plans offer 80 percent insurance coverage of essential benefits, and they have high premiums, moderate deductibles, and moderate to low out of pocket expenses.
  • Silver plans provide 70 percent insurance coverage of essential benefits. These plans range from moderate to high deductibles, and moderate to high out of pocket costs. Silver plans work well with health savings accounts.
  • Bronze plans cover 60 percent of essential benefits, and they have low premiums. Bronze plans have the highest levels of deductibles and out of pocket expenses.

The Reform of Plan Benefits

The law reformed health benefits to form the core of the new health care approach to detecting and treating preventable diseases. Available at no extra expense to the consumer, basic services establish baseline data such as symptom-free wellness. The ACA treats mental health as it does physical diseases; consumers can get mental health screenings, treatment, and including addiction treatment. The ten essential health benefits must not have dollar limits, either annual or lifetime limits.

Self-Employed Coverage

Self-employed persons can deduct the money paid for health insurance premiums from their taxable income. The deductibility of insurance premiums paid to cover self-employed persons and their dependents is a major advantage of the Affordable Care Act that benefits entrepreneurs. If the self-employed business adds, at least, one employee, it can qualify for tax credits and the small business Obamacare marketplace resources or SHOP.

Small Business Programs

Small business owners can get coverage for themselves and their families when providing health insurance coverage for their company personnel.The SHOP program also provides tax incentives for business organizations that cover employees.

Organizations with 49 or fewer employees are eligible for SHOP benefits.

Companies with 25 or fewer employees with annual average incomes below $50,000 can get tax credits. The highest level of incentives goes to small companies defined as less than ten employees with average annual wages of $20,000 or less. These small employers qualify for the largest percentage tax credit. Employers in this category can get tax credits worth up to fifty percent of the amount paid towards employee premiums.

Obamacare Coverage Focuses Prevention and Wellness

The overall purposes of the complete revision of the health care laws in 2010 are to improve the level of health in America and reduce the national costs of health care services. Health care reform is a comprehensive approach to national efforts to improve well-being, and it includes programs that reduce hospitalization risks, avoidable illnesses, and premature deaths. Emphasizing preventive medicine and wellness, the ACA reduces the demands for health care services while improving treatment outcomes. Comparison shopping is a proven method for discovering the particular benefits of qualified health plans that affect the applicant’s individual or family situation. It focuses the search on the parts of the coverage that matter most. Start comparing health insurance rate now by entering your zip code in our FREE tool below!

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