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Health Care Guide

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Affordable Care Act

hospitalThe Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA) or Obamacare, is a law that puts in place comprehensive health insurance  reforms that will be implemented in stages over a multi-year period.  The purpose of the law is to provide quality, affordable health care for all Americans.  It allows individuals, families, and small businesses to choose insurance coverage in an open, competitive insurance market.  The Act also requires insurance companies to provide more coverage, reduce costs, and provide healthcare to those individuals previously disqualified.

In California, Covered California is the marketplace for health insurance as well as the primary source of information about how the ACA is implemented for California residents and businesses.  For broader information about the ACA or information for states other than California, the official websites for the Affordable Care Act and the Health Insurance Marketplace (enrollment ends January 15 each year) are also available now.

Coverage

  • Ends Pre-Existing Condition Exclusions for Children: Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition.
  • Keeps Young Adults Covered: If you are under 26, you may be eligible to be covered under your parent’s health plan.
  • Ends Arbitrary Withdrawals of Insurance Coverage: Insurers can no longer cancel your coverage just because you made an honest mistake.
  • Guarantees Your Right to Appeal: You now have the right to ask that your plan reconsider its denial of payment.

Costs

  • Ends Lifetime Limits on Coverage: Most benefits are banned from having a lifetime limit on coverage for all new health insurance plans.
  • Reviews Premium Increases: Insurance companies must now publicly justify any unreasonable rate hikes.
  • Helps You Get the Most from Your Premium Dollars: Your premium dollars must be spent primarily on health care – not administrative costs.

Care

  • Covers Preventive Care at No Cost to You: You may be eligible for recommended preventive health services without a copayment.
  • Protects Your Choice of Doctors: Choose the primary care doctor you want from your plan’s network.
  • Removes Insurance Company Barriers to Emergency Services: You can seek emergency care at a hospital outside of your health plan’s network.

 

The exact language of changes enacted in 2018, for 2019 implementation can be found online in the Federal Register .

The California Health Care Foundation (an independent non-profit organization) provides an evaluation of current issues about the ACA.

Covered California

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In California, Covered California is the marketplace for health insurance as well as the primary source of information about the ACA is for California residents and businesses. 

Individuals and small business will be able to compare plans, ask questions, find out eligibility for tax credits or health programs, and enroll in a health plan.

Covered California EN ESPAÑOL

For broader information about the ACA or information for states other than California, the official websites for the Affordable Care Act and the Health Insurance Marketplace are also available.

The California Health Care Foundation (an independent non-profit organization) provides an evaluation of current issues about the ACA.