ObamaCare in South Carolina
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About Obamacare in South Carolina
There is a new way to get health insurance coverage in South Carolina, through the Health Insurance Marketplace. Health insurance plans acquired through the Marketplace are provided by private insurance companies and all of them provide coverage for core health benefits. When browsing for Marketplace plans, you will be able to compare non-essential benefits, process and quality of services.
When you apply for this affordable healthcare program, you will be able to determine if you qualify for financial aid to help you pay for private insurance or receive public coverage through Medicaid or the Children’s Health Insurance Program (CHIP). Open enrollment for Health Insurance Marketplace ended March 31, 2014. The coverage enrollment period for 2015 will start on November 15, 2014. Don’t forget that most people will be required to have health coverage or face the consequence of paying a penalty. For more information regarding Health Insurance Marketplace, go to: https://www.healthcare.gov.
Individual & Family Coverage
Marketplace health plans will provide coverage for essential healthcare benefits. These benefits include outpatient care, hospitalization, emergency room services, maternity care, newborn care, prescription drugs, laboratory services, pediatric services, mental health treatments and rehabilitative services. Besides these core benefits, each plan may offer additional services which can be verified before purchasing a plan.
Marketplace plans allow you to choose both healthcare providers without having to pay more if they do not belong to your plan’s network. You can also be treated at any out-of-network hospital without any penalty from your insurance company. It is advised to review the plan’s benefit summary to determine which prescription drugs are covered by the plan, as well as the in-network pharmacies that will offer lower out-of-pocket expenses.
If your business has fewer than 50 full-time employees it is considered a small business and you are not required by law to provide healthcare coverage for your employees. In case you wish to provide health insurance, you can get a plan from the Small Business Health Options Program (SHOP) Marketplace. This program is designed to assist small business owners in acquiring health plans for their workplace.
The employer has the ability to choose between four coverage levels: Bronze, Silver, Gold and Platinum. The coverage percentage paid by the insurance company will depend on the coverage level purchased. You will also be able to determine what portion of the employees’ premiums you want to pay. If your business has fewer than 25 full-time employees, you may also qualify for tax credits if you decide to purchase an insurance plan through SHOP.
Even if you were previously denied insurance due to a pre-existing condition, Marketplace insurance plans will provide coverage for those conditions, without charging higher premiums. Once you acquire a healthcare plan through this program, you will get coverage for treatment of new and pre-existing medical conditions like cancer, diabetes or disabilities. Medicaid and the Children’s Health Insurance Program (CHIP) are also obliged by these rules and they cannot refuse coverage or treatment.
All treatments will be subject to your plan’s deductibles, copayments or coinsurance. Grandfathered plans do not have to provide coverage for pre-existing conditions; however, you are able to switch to a Marketplace plan during the open enrollment period.