The Affordable Care Act (ACA) has sparked a lot of questions from those eligible for Medicare as to how ACA Marketplace plans and Medicare coverage work together. In a nutshell, they really don’t. If you are already on Medicare, nothing changes for you. You are considered covered under the health care law and do not have to explore other options through the Marketplace. In fact, it is against the law
Understanding Halbig v. Burwell – Can I Still Collect a Health Insurance Subsidy?
We recently learned the outcome of an important legal case with potential implications for health insurance reform. At issue in Halbig v. Burwell was whether or not the language in the Affordable Care Act (in the law itself) gives the IRS and the federal health insurance exchange the authority to distribute premium tax credits to individual policyholders. The argument is that the law states subsidies are available for policies purchased
Preventive vs. Diagnostic Medical Services Under the Affordable Care Act
The Affordable Care Act (ACA) mandates that all qualified health insurance plans (except grandfathered plans purchased prior to March 23, 2010 and still in place) include coverage for ten essential health benefits. That does not mean these medical services are necessarily free, merely that your health insurance will cover some or all of the cost. But certain preventive services are free. This means your health insurance must cover 100% of
What is the Employer Mandate?
One of the provisions of the Affordable Care Act (ACA) is the employer mandate. Employer Mandate Companies with 50 or more full-time or full-time equivalent employees must offer full-time employees and their dependents (i.e., children up to age 26) coverage that is affordable* and provides minimum value**. * affordable = employee pays no more than 9.5% of his/her household income ** minimum value = plan pays at least 60% of
Metal Plans Under the Affordable Care Act
The Affordable Care Act (ACA) created four new designs for health insurance policies. You may have heard policies referred to as “metal plans.” This is because each design is named after a metal: Bronze | Silver | Gold | Platinum The four metal plans are distinguished from one another by their actuarial value. Actuarial value (AV) is the average amount of covered health care expenses that will be paid for
New Virginia Law Changes Pediatric Dental Benefit for 2015
Coverage for pediatric dental care is considered an essential health benefit under the Affordable Care Act (ACA). Several months ago we wrote about pediatric dental coverage in Virginia (click here to read the original post). To summarize briefly, all 2014 individual and small group (50 or fewer employees) health insurance policies sold outside the federal exchange are required to include coverage for pediatric dental care. But for policies sold through
Short-Term Health Insurance
Now that the window of opportunity to purchase 2014 Affordable Care Act (ACA)-compliant health insurance has closed, many people are wondering how they can be protected in the event of an illness or injury this year. In most cases, if you did not purchase a 2014 policy before the March 31 deadline, your option for the remainder of 2014 is to purchase what’s known as short-term insurance. (*See notes below
Buying Health Insurance After March 31 During a Special Enrollment Period
March 31 has come and gone. And with it has come the end of open enrollment for 2014 health insurance plans. Unless you had already begun an application on or before that date through healthcare.gov (the federal health insurance exchange used by Virginia residents), March 31 was the last day you could purchase non-group health insurance coverage during 2014 open enrollment. However, there may still be an opportunity to purchase
Beat the March 31 Deadline for Health Insurance
You have until midnight on March 31, 2014* to beat the deadline for enrolling in 2014 health insurance coverage. *A qualifying event will allow you to enroll after March 31 Applying for Coverage Without a Subsidy If you are not eligible for a subsidy (click here to find out), you can enroll quickly and easily by filing an application directly with the carrier of your choice: CareFirst BC/BS Anthem BC/BS
Another Health Insurance Extension?
This week’s big news surrounding the Affordable Care Act was the Obama administration’s announcement of a partial extension to the March 31 deadline for enrolling in 2014 health insurance. Another extension? Sort of. Before you believe you now have longer to enroll, remember it is a partial extension. And in fact, the administration is careful to call it a special enrollment period rather than an extension. Who Can Enroll in
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