- 1 Introduction
- 2 Some Americans are covered under the Affordable Care Act (ACA), commonly referred to as Obamacare.
- 3 Others have insurance through their employer or can afford individual plans.
- 4 People who don’t have coverage and don’t qualify for government assistance often face expensive premiums, deductibles and co-pays.
- 5 In addition, millions of people face a deadline this year for signing up for coverage through Medicare or Medicaid.
- 6 This year, there’s even more confusion about what is affordable and how people can get coverage.
- 7 The health care system is complicated and often confusing
- 8 Conclusion
The U.S. health care system is complicated and confusing. That’s not surprising when you consider how many players are involved: insurance companies, government agencies, employers, doctors and hospitals all work together to deliver care to Americans. But even the average person can’t keep track of all the changes in this market from year to year—or even month to month! Here are some basics about health insurance coverage in America today that may help demystify what should be one of your top priorities as you plan for retirement or begin looking for a job:
Some Americans are covered under the Affordable Care Act (ACA), commonly referred to as Obamacare.
The Affordable Care Act (ACA), also known as Obamacare, is a federal law that requires people to have health insurance. It was signed into law in 2010 and has since been amended several times.
The ACA regulates the types of plans that can be sold on the individual market and how much insurers are allowed to charge for premiums based on age, location and smoking status. The act also mandates that all Americans must have some form of health coverage or pay a fine if they don’t comply with this requirement by March 31st each year
Others have insurance through their employer or can afford individual plans.
Others have insurance through the Affordable Care Act (ACA), commonly referred to as Obamacare. Under the ACA, people who earn less than 400% of the federal poverty level ($48,240 for an individual or $98,400 for a family of four in 2019) may qualify for subsidies that lower their monthly premiums and out-of-pocket costs.
Others have employer-sponsored plans that offer comprehensive coverage at little or no cost to them. The majority of Americans with health insurance are covered this way through jobs or government programs such as Medicare or Medicaid. A growing number have purchased private plans directly from insurers rather than through employers since passage of the Affordable Care Act required companies with 50 employees or more to provide coverage starting January 1st 2014; however some still opt to purchase directly from insurers because they find it easier than going through their company’s HR department first
People who don’t have coverage and don’t qualify for government assistance often face expensive premiums, deductibles and co-pays.
The cost of health insurance is often prohibitive for people who don’t qualify for government assistance. For example, a family of four with an annual income of $50,000 or less may pay as little as $0 per month in premiums and $5 per prescription under the Affordable Care Act (ACA). However, if you make more than that amount but still aren’t eligible for Medicaid or subsidies through the ACA marketplace exchanges, your costs will be much higher: premiums can range from $300-$900 per month depending on your location.
The ACA also requires everyone who purchases an individual plan to pay deductibles–a fixed amount that must be paid before coverage kicks in–and co-pays–a percentage of each service used that’s currently paid at checkout time but could eventually change into a flat fee system similar to how Medicare works today.* Deductions vary by plan type ( bronze , silver , gold ), age group** and geographical region*** .
In addition, millions of people face a deadline this year for signing up for coverage through Medicare or Medicaid.
Medicare is a federal health insurance program for people over 65 and some younger people with disabilities. You may be eligible if you have been receiving Social Security benefits or Railroad Retirement Board payments for at least two years, or if you’ve worked long enough to qualify for Social Security credits under the Federal Insurance Contributions Act (FICA).
Medicaid is a state and federal program that provides medical assistance to low-income individuals and families who cannot afford medical care on their own. It offers basic coverage at little or no cost to eligible individuals; however, there are certain eligibility requirements which differ from state-to-state as well as specific eligibility criteria within each state’s guidelines that must be met before being able to enroll into this program.
This year, there’s even more confusion about what is affordable and how people can get coverage.
The ACA is a complex law that’s difficult to understand, and even harder to navigate. It takes time and effort for people to figure out what their options are and how they can get coverage. As the third open enrollment period begins, there are tens of millions more Americans who have health insurance as a result of this law than there were before it was enacted in 2010. However, this year there’s even more confusion about what is affordable and how people can get coverage–and that could make things even harder for some people who need help navigating the system than usual
The health care system is complicated and often confusing
The government has made it easier to navigate by creating the Health Insurance Marketplace, which allows you to compare plans side-by-side and enroll in one that works best for you. There are many options for health insurance–from private plans offered by various companies, to state-based Medicaid programs, or even Medicare if you’re 65 years old or older.
There are also many ways of paying for your plan: some people pay monthly premiums directly out of pocket; others pay them through an employer; still others receive subsidies from the government based on income level (and other factors) so that their premiums cost less than they would otherwise be expected to pay on their own.*
Finally–and perhaps most importantly–there are several different places where individuals can go when seeking medical attention: private providers like doctors’ offices; public hospitals such as county hospitals; urgent care centers like those operated by large pharmacies such as Walgreens or CVS/pharmacy
We can’t stress enough how important it is to understand your options when it comes to health care coverage. You don’t want to get caught off guard by a big bill or worse yet, risk losing coverage altogether because you didn’t know about an upcoming deadline. We hope this article has helped clear up some of the complexities surrounding health insurance in America today so that you can make better decisions about your own care.