Does the Affordable Care Act Impact My Health Insurance Coverage?
By Tucker Thompson, Collin County LIVING WELL Magazine
This is a question I’m asked weekly by clients both under and over age 65. My article highlights some of the rules and coverage shared by all people, and then some of the rules that are unique to both age groups.
Today all insurance companies must offer specific preventative care services to policyholders without co-pays or deductibles, from vaccines, birth control, annual wellness exams, cancer, blood pressure and cholesterol screenings––to name a few. Insurance companies are no longer allowed to put “lifetime dollar limits” on how much care they will pay for if a policyholder gets sick. They can’t cancel a person’s coverage because they get sick either.
For people 65 or older, it’s illegal to be sold one of the Affordable Care Act “Marketplace Plans,” except for a few, well-defined exceptions (details can be found on www.medicare.gov). People 65 or older get health insurance through our government’s basic Medicare plan. If anyone wants coverage more comprehensive than basic Medicare, they can be offered Medicare Supplemental policies or Medicare Advantage plans. However, the only time seniors will be guaranteed an opportunity to buy this additional coverage, regardless of pre-existing medical conditions, is during their one-time “Open or Special Enrollment Period” that starts when a person is either turning 65 or if they’re already 65 and they’re coming off a group plan they’ve been on through their own or their spouse’s employer. After the “Open Enrollment Period,” people have to qualify medically if they want to buy or switch their Medicare Advantage or Medicare Supplement Plans. There are usually only a few months each year you can switch “Advantage” plans, but you can buy new or change Medicare Supplements any time.
For people under 65, the new healthcare laws make it illegal to deny health insurance to anyone (including children) because of pre-existing conditions. In Texas, there are five different levels of coverage to choose from, each with different monthly premiums and out-of-pocket costs. Financial aid based on income has been expanded to help ensure all people are covered.
Tucker Thompson, the author, has worked in the insurance field over 20 years. He is often a guest speaker on topics related to the ever-changing health insurance landscape. His time is also spent helping individuals review or sign up for new medical insurance, Medicare, Medicare Supplements, Medicare Advantage Plans and policies available for people under age 65. With clients all over Texas, he may be reached locally at 972-548-1629 or toll free 888-247-1829.