ObamaCare in Illinois
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About Obamacare in Illinois
The Affordable Care Act, commonly known as Obamacare, is a health care reform that is trying to increase the accessibility, availability and affordability of health insurance for all citizens. If you are currently uninsured, keep in mind that this new law requires that most people get health insurance by 2014. Failing to do so may result in a penalization on your 2015 income taxes. Illinois residents can access the Health Insurance Marketplace to apply for private or public insurance. Your application information will determine if you qualify for private health insurance, Medicaid or the Children’s Health Insurance Program (CHIP).
Details regarding your income and household size may also deem you eligible for insurance financial assistance or lower cost plans. 2014 open enrollment for Marketplace ended on March 31. You may visit the Health Insurance Marketplace website at: https://www.healthcare.gov. There are some eligibility exceptions that may allow you to qualify for special enrollment period. Otherwise, keep in mind that open enrollment for 2015 begins on November 15, 2014.
Individual & Family Coverage
When you acquire a health plan from the Health Insurance Marketplace you can be assured that you will receive the basic health coverage you and your family may need. There are minimum coverage requirements specified called essential health benefits and all plans must adhere to these basic coverage outline. The essential benefits include hospitalization, doctor appointments, emergency services and prescription drug fillings. All plans will also provide covered mental health treatments, laboratory services, maternity care, pediatric care, rehabilitation services and devices, ambulatory services and behavioral treatments.
The new health reform states that Marketplace plans should provide preventative and wellness services that do not require payment of deductibles, copayments or coinsurance. These preventative services include vaccinations, flu shots, diet counseling and blood screenings, amongst others. Some plans may also offer additional coverage like dental or vision insurance.
In Illinois, small businesses with less than 50 full-time employees are eligible to use the Small Business Health Options Program (SHOP) Marketplace. Business owners can search for affordable health plans, and compare benefits and costs. There are four coverage levels available to choose from. Each level corresponds to the portion of costs covered by the insurance carrier and the employer may choose the level that works better for their business. Another advantage of purchasing health plans through SHOP is the ability to decide what percentage of the employee premium you, as an employer, want to pay.
Business with fewer than 25 full-time employees or its equivalent may also be eligible for health care tax credits. If you qualify for this incentive, you can save up to 50 percent of your premium costs. If you are interested in purchasing insurance for your workforce, you may browse for both health and dental plans at: https://www.healthcare.gov/find-premium-estimates/.
All Health Insurance Marketplace plans provide coverage for pre-existing conditions. Even if you were refused coverage in the past due to a pre-existing medical condition, the new healthcare reform indicates that insurance providers must provide coverage for such conditions. When you purchase a health plan, you will be entitled to treatment for conditions like chronic pain and diabetes.
Medicaid and the Children’s Health Insurance Program (CHIP) are bound by the same law and they cannot refuse covered treatment either. However, if you have a grandfathered individual health plan, you may be denied coverage, as these plans are exempt of many of the Obamacare reforms. If this is the case, you can switch to a Marketplace plan that will guarantee coverage for your pre-existing medical conditions.