Affordable Care Act


In 2010 the Patient Protection & Affordable Care Act was signed into Law covering people ages 0-64

Over the last four years many of the provisions were introduced; most noticeable:

–      Young adults, up to age 26, could stay on parents health plan

–      Medicare beneficiaries, faced with prescription coverage gap or “donut hole”, received a significant cost break

In January 2014 the center piece of the Law goes into effect – The Individual Mandate – where all American’s are required to carry some form of health insurance-either through Work, the Marketplace or Medicare/Medicaid

Michigan’s legislative body failed to pass a bill establishing a Michigan run exchange

Gov. Snyder recognizing the importance as well as the legality of the ACA Law accepted on behalf of Michigan’s citizens a Federally-facilitated Exchange (also known as the Marketplace)

The Exchange opened on Tuesday October 1, 2014 @ www.HealthCare.gov with 4.3 million people signed up as of March 1, 2014 nationally.

In Michigan out of 313,644 individuals eligible to enroll in a marketplace plan 144,587 have selected a plan as of March 1, 2014.

It’s hasn’t been easy but the majority of kinks have been worked out and www.healthcare.gov is functioning well.

There are still issues once in a while-but there are issues with every web site and application you use.

When Facebook is slow or unresponsive you grumble but you either wait or reboot the app. There isn’t a person to call to get help-you just wait

When Healthcare.gov is unresponsive you have the option of waiting or calling a real live person who will assist you immediately and get you signed up

1-800-318-2596

The initial enrollment period is from October 1, 2013 through March 31, 2014

After the 2014 enrollment period the ACA enrollment period will run from October 15th  to December 7th and coincide with Medicare’s Annual Enrollment Period

There will be “special enrollment” periods for life changing situations (i.e. marriage; birth; death; unemployment)

There are 13 insurers offering plans on the Michigan Health Insurance Exchange

  • Alliance Health and Life Insurance, Detroit (a subsidiary of HAP)
  • Blue Cross Blue Shield of Michigan, Detroit
  • Blue Care Network of Michigan, Detroit
  • Consumers Mutual Insurance of Michigan, East Lansing
  • Health Alliance Plan, Detroit
  • Humana Medical Plan of Michigan, Louisville, Ky.
  • McLaren Health Plan, Flint
  • Meridian Health Plan of Michigan, Detroit
  • Molina Healthcare of Michigan, Long Beach, Calif.
  • Priority Health and Priority Health Insurance, Grand Rapids (plans offered under two licenses)
  • Total Health Care USA, Detroit
  • United Healthcare

 

Not all carriers and plans will be available in all parts of the State.

Some will offer multiple plans for different geographic locations; but all must offer at least three levels of coverage:

  • Bronze –  which is an 60%/40% coverage level
  • Silver – which is an 70%/30% coverage level
  • Gold – which is an 80%/20% coverage level
  • Platinum – which is an 90%/10% coverage level

1,072,508 (94%) of Michigan’s uninsured and eligible population may qualify for either tax credits to purchase coverage in the Marketplace or for low cost/no cost Medicaid coverage

  • No one can be turned away due to pre-existing conditions
  • There is no annual or lifetime caps on coverage
  • Although all plans offered have deductibles and copays there is a long list of no cost/no copay preventative services for all adults and children:

The Marketplace has been designed for people in your situation

  • 94% of Michigan’s uninsured and eligible population can benefit from the Marketplace’s offerings
  • You can receive income based assistance, in the form of a tax-credit, to pay for your premiums, lower out-of-pocket costs
  •  If your income qualifies you may get coverage free or almost free through Medicaid or CHIP for your kids
  • Subsidies are available based on income up to 400% of the federal poverty level

The ACA is your opportunity to have quality health coverage at an affordable cost