In a year devoted to sifting through the rhetoric of candidates seeking election or re-election, much of the health insurance reality was lost amidst partial truths and outright untruths. So, where do we stand with health insurance and where are we going? Take the quiz below to begin to rate your health insurance IQ.
1) Does the Affordable Care Act mean that every American will have health insurance?
2) Does the Affordable Care Act mean that every American will be able to afford healthcare?
3) Has the Affordable Care Act changed the process of getting health insurance if we need it?
4) Do essential health benefits mean that I’ll be able to get better mental health services coverage?
5) Will more doctors take my insurance?
6) If I don’t have health insurance will I have to pay a fine?
7) Will Affordable Care prevent me from going bankrupt if I get sick and need treatment?
8) Do I pay a lot less for health insurance coverage under the Affordable Care Act?
9) Will I get great insurance coverage that is the same regardless of the state in which I live?
10) What are my out-of-pocket expenses called on my bills?
11) When does the Affordable Care Act become effective?
12) Is Affordable Care a done deal or might there still be changes?
13) If I am eligible for a tax credit and/or subsidy based on my low income, will I have to pay those expenses out-of-pocket before getting reimbursed?
Here are your answers: 1) No. The goal is to get Americans insured but YOU must act to get your insurance by enrolling and paying premiums. 2) No. There are few to no cost controls on the expense of healthcare. The Affordable Care Act addresses health insurance as a necessity for obtaining healthcare but does not guarantee you will be able to afford needed healthcare. 3) Not yet. But in 2014, States will have Healthcare Exchanges that are designed to provide easy access for individuals looking for health insurance policies. 4) Yes. For plans that qualify under the Affordable Care Act, beginning in 2014, mental health services will be covered. Currently plans do NOT have to provide such coverage, but if they do they must treat mental health services like other medical services in terms of co-payments and co-insurance payments (parity). 5) Unknown. No doctor is required to take any insurance and many have threatened that they will not accept health insurance. Always check with your insurance company regarding whether a physician is an in-network provider AND also check with the physician’s office at the time you make an appointment. 6) Yes. While designated as a tax rather than a fine, you will have to pay a tax if you do not purchase health insurance. That tax will not mean that you are insured, you still have to purchase insurance, so you have to pay an added fee because of your delay in purchasing health insurance. 7) Not necessarily. Medical costs can add up quickly. Even if you meet your deductibles, your rate of coverage for specific services under your contract may be a percentage less than 100 percent which means that you’ll still have to pay something for services regardless of how much you’ve paid out-of-pocket. 8) No. Insurance costs have been rising steadily for many years. If you meet certain low-income requirements you will become eligible for tax credits and/or subsidies to help pay for health insurance and health costs such as co-payments, but insurance costs, in general, continue to rise. 9) No. State coverage will vary and therefore the establishment of different plans will vary based on the state in which you live. A bronze plan in one state could be different from a bronze plan in another state. 10) In addition to insurance premiums, you are responsible for paying co-payments, deductibles, and co-insurance, which covers the discrepancy between what your plan covers for specific care and services and what they cost (for instance if your plan covers 80 percent of x-ray services you will always have to pay 20 percent of those costs). Depending on whether you use an in-network or out-of-network provider, the total cost charged for your service will vary with in network being less expensive, but you will still have to pay co-payments, co-insurance and deductibles. 11) The Affordable Care Act has many of its provisions becoming effective in 2014 and many provisions that will gradually become effective after that. Right now you may start to see insurance plans covering various aspects of the Affordable Care Act but that depends on the insurance policy produced by the insurance company. 12) Not only might there be changes, but there are likely to be changes made to the Affordable Care Act as rules for implementation are enacted. There have already been changes made, including those modifying deadlines (such as those for notifying the federal government of state intentions regarding health exchanges). Issues surrounding funding are also not a done deal. The Supreme Court ruled the majority of the law Constitutional, it did not preclude legislative and other changes to the law. 13) No. FPL, the Federal Poverty Level, will be used to help individuals with low income qualify for assistance in the form of a tax credit or subsidies under Affordable Care. These credits, beginning in 2014 are designed to be taken in advance so that you should NOT have to pay the money out of pocket and wait for reimbursement if you qualify.
