Changes to the Affordable Care Act – Individual Health Insurance
In today’s uncertain world, quality health insurance is a necessity. Medical care is more expensive than ever, and if you’re not covered under an employer’s plan, even the smallest issue can set your budget back months. While the Affordable Care Act (ACA) was signed into law in 2010, important changes have taken place recently that may impact individual health insurance and how you secure reliable coverage.
The Individual Mandate Was Repealed – Effective in 2019
One of the biggest changes to the ACA is the recent repeal of the individual mandate, also called the “shared responsibility payment.” Originally, if you could afford to buy health insurance, but chose not to, you were subject to a fine or penalty. In 2017, the fine for an adult without creditable health insurance was $695.
In December of 2017, Congress passed a national tax bill, which repealed the individual mandate. Starting in 2019, individuals will no longer face a penalty for not enrolling in an ACA compliant health plan.
Association Plans Have Been Expanded
The length of time Association Health Plans (AHPs) can cover individuals has been expanded and people can now pay for AHP coverage with health reimbursement agreements, like HSAs and savings accounts.
Pre-Existing Conditions and Coverage
Under current law, it is illegal for health insurance companies to refuse to cover you or charge you more because of a “pre-existing condition” (a health problem you had before new health coverage starts). Companies may not limit benefits associated with treating your condition, and once you are insured, cannot refuse to cover treatment.
Any group or individual health insurance policy that was purchased on or before March 23, 2010 is considered a “grandfathered” plan, exempt from many changes required under the Affordable Care Act. Plans or policies may lose grandfathered status if they make significant changes that reduce benefits or increase costs to consumers.
By law, any health plan that considers itself to be grandfathered must disclose this information in its plan materials. They must also advise consumers how to contact the U.S. Department of Labor or the U.S. Department of Health and Human Services with questions.
Note: The date you joined a group health plan may not reflect the date the plan was created. And, new employees and new family members may be added to grandfathered group plans after March 23, 2010.
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