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Health_Care_Reform

What’s new in private health insurance?

The new health care law is making private health insurance easier to buy and more affordable. The law also improves customer protections.

Buying insurance is simpler

You are able to buy good, affordable insurance through the online Health Insurance Marketplace.

The search for health insurance is simpler because all of your options are gathered in one place. One application allows you to explore every qualified insurance plan in your area, along with Medicaid, $0 premium or low-cost insurance programs you qualify for. You are able to apply and get help online, by mail, by phone or in person.

You will get a break on the cost of insurance

Health insurance in the Marketplace is also be more affordable. If your annual income is within 100—400 percent of the federal poverty level (FPL), you are eligible for a type of tax credit that lowers your monthly premiums. The less you make within the income range, the more help you will get.

Incomes that will qualify for help

Family sizeAnnual income range*
1$11,490 − $45,960
2$15,510 − $62,040
3$19,530 − $78,120
4$23,550 − $94,200
5$27,570 − $110,280
6$31,590 − $126,360

*Slightly higher in Alaska and Hawaii.

Your options are explained in plain language

You get clear information in plain terms about prices and benefits so you can compare your options before you choose a plan.

Plans cover health, mental health and substance use services

Every health insurance plan in the Marketplace cover ten types of services, or “Essential Health Benefits”. Services include mental health care, doctor’s visits, emergency department visits, hospital care and prescription drugs.

Mental health and substance use services must be covered at parity, or on fair and equal terms compared to services for other medical conditions.

Stronger customer protections help you and your family

  • Parents now have the option to keep young adult children who don’t have job-based insurance on their plan until age 26 even if they are working or living independently.
  • Plans cannot put lifetime limits on basic health and mental health care.
  • Annual limits are not allowed for essential health benefits.
  • Plans are not allowed to turn you down, limit coverage or charge you more if you have a mental illness. They cannot cancel your coverage when you get sick or use more services.
  • Plans must accept you if you apply for coverage and must renew your plan before it expires. If you want to change your plan, you may switch during the open enrollment period.
  • Plans are not allowed to charge different rates based on your gender or health problems. Plans can charge different rates depending on your age, tobacco use, family size and where you live, but rate differences are limited by law.

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