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Demystifying The Health Care Law
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Agenda Supreme Court’s Ruling
What the health care law means for:
People with health insurance People who are uninsured or buy their own coverage People with Medicare People planning for their long-term care AARP’s Health Law Guide
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Supreme Court Decision
The Supreme Court ruled that the majority of the critically important provisions of the Affordable
Care Act are constitutional
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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
Things You Need to Know
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Ends discriminatory 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 lifetime and annual coverage limits Insurance companies can’t place lifetime limits
on your coverage (Now)
Insurance companies can’t place annual limits on your coverage (2014)
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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
Things You Need to Know
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Creates Health Insurance Exchanges
Makes it easier to buy health insurance
Offers health insurance plans by 2014
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Creates Health Insurance Exchanges
Offers comprehensive benefits
Several levels of coverage
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Provides Help Paying for Insurance
Starting 2014 For health insurance purchased through an
exchange
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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: Live with you Are married Are no longer in school
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Option for States to Expand Medicaid Starts in 2014 Your state has the option to expand coverage to
more people Must meet income limits to be eligible
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Provides temporary coverage for people with pre-existing conditions
“Pre-Existing Condition Insurance Plan” (PCIP) You must be uninsured for at least 6 months and
have a pre-existing health condition
Information about the PCIP in your state is available NOW!
www.pcip.gov
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Provides temporary coverage for people with pre-existing conditions
Covers a range of benefits
Covers pre-existing conditions
Ends when exchanges start in 2014
www.pcip.gov
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People Who Have Medicare
Things You Need to Know
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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
2012: 50% discount on brand name drugs; 14% discount on generics
By 2020:
• Coverage gap will disappear • Part D cost sharing will remain
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Medicare Drug Coverage
50% discount for Brand Name
and 14% for Generic
Initial Benefit Catastrophic Benefit
You pay: Deductible and 25% of drug costs
You pay: 5% of drug costs
Doughnut Hole
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Covers more preventive services
Adds a free annual wellness visit
Expands coverage for preventive care
No copayments or deductibles for Medicare-approved preventive care
Call Medicare at 1-800-633-4227 www.medicare.gov
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People Receiving for Long-Term Care
Things You Need to Know
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More information about nursing homes
Makes it easier to file complaints
Extends financial protections
www.medicare.gov/NHcompare
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Key points to remember about the ACA: Increases consumer protections
Makes health insurance more accessible
Improves and expands Medicare-covered benefits
Increases protections for people in nursing homes
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For More Information Visit
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www.aarp.org/healthlawguide
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Upcoming Web Events
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www.aarp.org/healthwebinars