the health care law: things you need to know. welcome 2
Post on 03-Jan-2016
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The Health Care Law: Things You Need to Know
Welcome
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What the law means for people: With health insurance
Who are uninsured or buy their own coverageWho are small business owners Who have Medicare Who receive long-term care
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Supreme Court Decision
• The individual mandate is constitutional
• States have the option to expand Medicaid
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What’s Next?
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People with Health Insurance
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Ends unfair insurance practices
Insurance companies can’t drop coverage if you get sick (Now)
Insurance companies have to justify increases to premiums (Now)
Children under age 19 can’t be denied coverage for a pre-existing condition (Now)
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Eliminates coverage limits
Insurance companies can’t place lifetime limits on your coverage (Now)
Insurance companies can’t place annual limits on your coverage (2014)
Requires coverage for preventive services
Applies to most insurance plans
Covers more preventive care Mammograms Immunizations Screenings for cancer
or diabetes
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People Who Are Uninsured Or Buy Their Own Coverage
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Creates Health Insurance Marketplaces
Makes it easier to buy health insurance
Starts in 2014
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Creates Health Insurance Marketplaces
Core benefitsSeveral levels of coverageEasier to compare benefits and costs
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Provides Help Paying for Insurance
Starts in 2014For insurance purchased through a Marketplace
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Extends coverage to young adults
Adult children can stay on your policy until age 26
Adult children can be covered even if they: Don’t live with you Are married Are no longer in school
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Option for States to Expand Medicaid
Starts in 2014
Option to expand
Meet income limits
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Small Business Owners
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Businesses with < 100 employees can buy insurance through the Marketplace
Businesses with < 50 employees pay no penalty if they do not offer coverage
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More options to offer employees
Tax credits to offset insurance costs
If < 25 employees with average wages < $50,000
If pay 50%+ of employee health insurance
www.IRS.govwww.smallbusinessmajority.org
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Other benefits for businesses with up to 100 employees
“Simple Cafeteria” plans
Wellness program grants
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People With Medicare
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For People with Medicare
Protects guaranteed Medicare benefits
Improves Medicare benefits
Lowers out-of-pocket costs for prescription drugs
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Lowers out-of-pocket drug costs
The doughnut hole will gradually disappear
2013: 52.5% discount on brand name drugs; 21% discount on generics
By 2020:
• Coverage gap will disappear• Part D cost sharing will remain
Medicare Drug Coverage
Discount:52.5% Brand 21% Generic
Initial Benefit Catastrophic Benefit
You pay: Deductible and 25% of drug costs You pay: 5% of drug
costs
Doughnut Hole
www.aarp.org/doughnuthole
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Other Changes to Medicare Part D
Income-related premiums
For those with Part D
Income levels $85,000 = single person $170,000 = married couples
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Covers more preventive services
Yearly wellness visit More health screenings No copayments or deductibles
for approved preventive care
Call Medicare at 1-800-633-4227
www.medicare.gov
People Receiving Long-Term Care
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More information about nursing homes
$ spent on resident careStaff turn-over Easier to file complaints
www.medicare.gov/NHcompare28
Key points to remember:
Increases consumer protections
Makes health insurance more accessible
Improves Medicare benefits
Increases protections for people in nursing homes
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www.aarp.org/healthlawguide
Questions and Answers
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For more informationThe health care law
www.aarp.org/healthlawguidewww.aarp.org/guiadelaleydesalud
Medicarewww.medicare.gov 1-800-633-4227
Insurance plans in your stateState Health Insurance Assistance Program www.SHIPtalk.org 1-800-677-1116
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Has the Health Care Law helped you?
Share your personal storywww.aarp.org/shareyourthoughts
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www.aarp.org/healthlawguide
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