Health Insurance Reform
The Affordable Care Act, in an attempt to provide affordable health insurance to all Americans, has made many changes which became law, effective January 1, 2014. For some, that means that they will receive access to a medical insurance plan at a reduced cost (based on their IRS calculation); for others, it means that their plans have had to change to meet the new requirements, their old plans may no longer be available, they may need to keep their grandfathered plan, and/or that their costs are rising.
Here are some of the changes which took effect on January 1, 2014, which may have affected you:
- All health plans for individuals and small businesses must include the 10 Essential Health Benefits
- You cannot be denied medical insurance coverage by an insurance company due to a pre-existing medical condition.
- Medical insurance companies cannot place a yearly or lifetime dollar limit on essential health benefits.
- Medical Insurance plans are available in four levels of "full" coverage - Bronze, Silver, Gold, and Platinum - plus a Catastrophic plan ~ The Washington state Medicaid program has been expanded to cover more low-income people.
- If you are under age 65, and are not covered by your employer, Medicare, or Medicaid, you may qualify for assistance that will help you save on monthly premiums, copays, and coinsurance costs
- If you live in Washington state, you will be able to identify any federal tax credits for which you may be eligible, and make side-by-side comparisons between health plans on the Washington Healthplanfinder website
At WaHIP, we are dedicated to helping you navigate through these changes, and finding the plan that is the right fit for you.
10 Essential Health Benefits
The 10 Essential Health Benefits which must now be present in all individual and small business medical insurance plans include:
- Emergency Care - includes care for conditions which, if not immediately treated, could lead to serious disability or death
- Hospitalization - includes room and board, medical care, tests, and prescription drugs administered during your stay
- Ambulatory Patient Services - includes care you receive without being admitted to a hospital, such as services at a clinic, physician's office, or same-day surgery center
- Maternity and Newborn Care - includes care provide during pregnancy, during and after labor, and care to newborn children
- Mental Health Services - includes services for substance abuse and behavioral health treatment, including evaluation, diagnosis, and treatment services
- Prescription Drugs - includes drugs for treating urgent health issues and chronic conditions
- Rehabilitative and Habilitative Services - includes devices to help people with injuries, disabililties, and chronic health conditions
- Laboratory Services - includes tests to diagnose conditions and monitor treatments
- Preventative and Wellness Services - includes routine physicals, screenings, immunizations, and chronic disease management
- Pediatric Services - includes dental and vision care appointments and hardware
Find us at:
If you navigate to the Washington Healthplanfinder through our website, you will have access to our assistance at any time, at no cost to you. However, based on our experiences so far, we recommend you do not fill anything out without direction or you may be incorrectly calculated. Once information is entered, it is difficult to correct it.
To return to the WaHIP website, just cancel or close this window. Otherwise, continue to the Washington HealthPlanFinder website. Thank you!
