Here is what the residents of California should expect from their health plans after the Affordability Act is implemented.
1. 503,000 small businesses in California will be encouraged with federal tax subsidies if they offer health coverage to their employees. At present, only a few small firms provide health insurance plans as they have to pay 18% more as compared to large companies.
2. 382,000 Medicare beneficiaries in California, who have hit the donut hole and had to pay the full costs of their prescription drugs, will be provided with a one-time rebate check of $ 250.
3. A temporary federal funding of $ 5 billion will be available to the 430,000 early retirees in California. This will enable them to access affordable health insurance plans through their previous employers.
4. There would be no lifetime limits and annual limits will be phased out protecting 19 million residents of California from running out coverage
5. Those 2.7 million residents in the state who have purchased their health plans from dishonest insurance practices will not dropped from coverage when they fall sick
6. Children with pre-existing medical condition will not discriminated and provided with health insurance California. Adults with pre-existing health condition will be able to access affordable healthcare through a high risk pool program worth $761 million federal dollars.
7. The Act brings good news to 196,000 young adults in the state who will be able to stay in their parents’ health plans(Health Insurance California) till they turn 26. This will ensure that they have medical coverage when they are studying or are looking for work
8. The patients’ choice of doctors will be protected and those applying for new health plans will be able to pick any participating primary care provider.
9. Women in California:
- Will not need prior authorization to consult an ob-gyn
- Will not face gender discrimination
- Will have to pay more to receive the same coverage as male of the same age and health status
- To double the patient intake in the existing 1049 Community Health Centers and to build more health centers
- $1.5 billion dollars will be funded to the National Health Service Corps over a period of five years to cater to the 9% of the Californian population that lives in underserved areas
- Make Medicaid health plans more flexible so as to accommodate more people from the low-income population irrespective of age, disability and family or health status.
A health plan is a contract between a health insurance company and an individual. The contract makes the individual eligible for healthcare service benefits as long as in pays a certain sum of money regularly. The contract can be renewed monthly or annually. The type of coverage and the amount of costs are specified in advance in the policy.
While purchasing health plans, there are several costs that are involved that the individual(s) to be covered need to pay. Here is a look at all the expenses that an individual will incur when he wants to buy a medical policy.
1. Premium: A premium is the amount that you need to pay to purchase health plans or to keep it valid.
2. Deductible: This is the amount that a person needs to pay from his pocket before the insurer starts paying for your medical bills. For example if you have a deductible of $300, then you need to pay for all your medical expenses till it adds up to $300. The carrier will start paying only after you have spent $300 on your health expenses.
3. Co-payment: Having access to health plans does not mean that the entire amount is taken care of by the insurance company. A part of the bill is to be shared by the individual and this is known as the co-pay. Co-pay has to be paid every time a healthcare service is availed. If you have a co-pay of $30, that means that in a doctor’s fees of $70, you pay 30 and your insurance company pays for the rest of the $40.
A combination of the premium, the deductible and the co-pay decides if the health plan that you are buying is cheap, affordable or costly.
