The Affordable Care Act (ACA) is the law of the land in the US, regardless of your political leanings on health insurance reform. Beginning in 2014, many of the ACA key provisions took effect, and the US government will enforce the “pay or play” penalty on individuals without health insurance. Certainly, changes will come to the ACA over time.
Today, you and your family need straightforward answers from a texas insurance broker on how to meet the ACA requirements to avoid paying a tax penalty in 2015 and beyond.
What Are the ACA’s Requirements?
The ACA states that health insurance policies must now provide a minimum level of essential health benefits. Most of these essential health benefits were already included in a typical health insurance policy before the ACA.
The law mandates that all ACA-compliant health plans cover:
- Ambulance services
- Emergency room and hospital stays
- Newborn and maternity health care
- Substance-use disorder services
- Mental health services (plus behavioral health treatments)
- Prescriptions
- Preventative and rehabilitative healthcare services
- Wellness programs
- Laboratory services
- Pediatric health care (plus dental and vision coverage)
In 2014, the fees for not having health insurance will be $95 per individual, $47.50 per child under 18 years old with a family’s maximum penalty capped at $285 or 1% of household income.
To avoid paying the tax penalty for not having health insurance, which increased in 2015, the health plan you buy must have these essential health benefits to be ACA-compliant.
Where to Get Health Insurance
The ACA changes the way health insurance works in the US. A large number of people in the US already have health insurance coverage via their employer-sponsored health plans. The ACA explicitly states that you have the right to shop for your health care coverage within or outside of the government’s health insurance marketplace.
The US government does not mandate that individuals use the “Obamacare” marketplace. You have the option to take advantage of the ACA tax credits and subsidies to afford health insurance, perhaps for the first time.
You have the option to select a custom family health plan outside of the health insurance exchanges, which may be the better option for you and your family’s health care needs.
Ideally, the health insurance marketplace will allow you to price-compare subsidized health plans versus complementary health plans on the private health insurance market.
To get health insurance today, you should talk to a knowledgeable insurance advisor to understand which option is the best choice for your financial situation.
Please contact us to speak to a Custom Health Plan Specialist today!
