The Affordable Care Act, aka Obamacare, included a number of changes designed to improve insurance for consumers.
Here’s a refresher on some of the provisions most likely to affect you:
* Young adults up to age 26 can remain on their parents’ health plan.
* Insurers can’t deny coverage to people with pre-existing health conditions or charge them more.
* Insurers can’t cap how much they’ll spend on you over your lifetime, and there are limits if they want to cap how much they spend on you each year.
* Insurers can’t cancel your coverage willy nilly. Unless you defraud them.
* States are required to review “unreasonable” insurance premium increases.
* Prescription drug discounts are available for seniors on Medicare.
* All new plans must cover certain preventive health services, such as mammograms and colonoscopies, without charging a deductible, co-pay or co-insurance.
* Insurers must spend at least 80 cents out of every premium dollar on your benefits and improving your care, rather than on corporate jets, plush offices and other overhead costs/profits.
* Your plan must cover mental health and substance abuse treatment much the same way it covers medical care, like surgery.
Supreme uncertainty: The future of the Affordable Care Act in Maine
Here’s what to expect from year two and beyond for the ACA in Maine.
Lewiston insurer is a national ‘rock star’
Today, a year after it started offering health insurance from its Lewiston headquarters in the Bates Mill, Maine Community Health Options has more than 40,000 members.
Profiles of Mainers who bought health insurance through the ACA marketplace:
- Barb Gabri: ‘Rolling the dice’ without insurance
- Charlene Brousseau: Sticking with the ACA
- Sherri Tripp: ‘I think it’s wonderful’
- Blake Pooler: Finally insured, for $160 a month
- $22 a month: ‘I am totally flabbergasted’
- Business owner: ACA offered another option
You’ve seen how the Affordable Care Act affected other Mainers in 2014. How about you? Good, bad or neutral — share your ACA stories
Resources:
- How the ACA changed your insurance
- Who are the health insurers competing for Mainers’ money
- Where to get help
- Tips, hints and other things you need to know
- Get insurance: The step-by-step
- Answers to frequently asked questions
- Know the lingo
- ACA by the numbers
From ‘hellish’ to health care: The ACA in Maine, one year later
A one-year checkup on how the ACA is doing in Maine and a subsidy calculator can be found at SunJournal.com/ACA201
Affordable Care Act 101: We break down the ACA, what it does and what it requires you to do.
Send questions/comments to the editors.
