On January 1, all the provisions of the Patient Protection & Affordable Care Act (ACA) went into force. While many of us have been bombarded with the more complex ACA issues, not a lot of ink is being given to many simple, yet important, changes.
Here is a reminder of some key changes to help you get the most from your policy.
- Emergency Services: Policies have to cover ER care. Previously pre-authorization from insurers was often needed for illnesses requiring an ER visit.
- Preventive Care: Most policies now include free preventive care, like regular annual physicals. You’re now guaranteed at least one free annual wellness visit.
- Prescription Drug Coverage: Your policy will now cover at least one drug in each category and medication class, or alternatively, must cover the same number per class as the benchmark plan. A benchmark plan is comparable to the average plan in your state. You’ll still be responsible for co-payments, but whatever you pay goes towards your annual out-of-pocket maximum.
Remember that, under the ACA, you are required to have a health care insurance plan or a penalty will be levied on your income tax return. In 2014, the fines are: $95 per adult and $47.50 per child.
If you are still confused, your insurance agent can help decipher the ACA for you, and if you haven’t already got a policy, you can obtain it through him or her.
NOTE: Changes to the ACA may have occurred after this newsletter was written. Call us for updated information.