Launched in 2010, Obamacare, or the Affordable Care Act aims to make health insurance affordable in the USA. Moreover, it protects customers from the tactics of insurance companies to increase patient costs or limit care. Thanks to the ACA, millions of Americans now have health insurance.
The ACA has an open enrollment period every year in which one can compare and choose health plans for the upcoming year. Usually, the open enrollment period is held between November 1 and January 15, though the exact day may vary based on state. For those looking to start their coverage on January 1, they will need to enroll by December 15.
In this blog, we will walk through the key benefits of enrolling in Obamacare. Let’s get started.
Affordable Health Insurance:
The obvious benefit of enrolling in Obamacare is that you get affordable health insurance. And this advantage comes into play when you are slapped with a hefty medical bill.
Earlier, many insurance plans would come with high deductibles and low maximum coverage. To tackle such “catches” of policies, ACA took various landmark steps. One of them was the introduction of tax credits for insurance to middle-class people.
Insurance companies must now use at least 80% of premiums on medical care and improvements. The ACA also prevents unreasonable rate increases.
By capping out-of-pocket expenses at $8,150 for individuals and $17,100 for families, and expanding Medicaid for those above the poverty line, health insurance has become more affordable for many.
Plus, the ACA lets parents keep their kids on their plans until age 26. There’s also a perk for small businesses: the Small Business Health Care Tax Credit.
This credit can cover up to 50% of the cost of providing health insurance to their employees, making it a big help for businesses with fewer than 25 full-time employees.
Get Coverage for Pre-Existing Health Conditions:
If you had a preexisting condition like cancer, it was tough to get health insurance before the ACA, as many insurers wouldn’t cover it if the condition was already there when you applied.
But now, thanks to the ACA, you can’t be turned away from coverage because of a preexisting health issue.
This ensures that everyone has access to the care they need, regardless of their health history.
Improved Access to Prescribed Drugs:
The ACA made a real difference in access to prescription drugs. By broadening Medicaid eligibility and enhancing the Medicaid Drug Rebate Program, it made both brand-name and generic medications more available to low-income Americans while also helping to reduce costs for taxpayers.
Before the ACA, 9% of individual market plans didn’t include prescription drug coverage. The ACA changed that by requiring marketplace plans to cover at least one drug in every class and to apply out-of-pocket drug expenses toward a beneficiary’s deductible. It also expanded the 340B drug discount program to include more providers, such as critical access hospitals and rural referral centers.
The ACA also made it easier to approve biosimilars, which are similar to generic versions of expensive biological drugs. This was intended to boost competition and lower drug prices, making new treatments more accessible.
More Screenings and Preventive Services:
With the ACA, you’ll find that many screenings and preventive services are now covered with low copays or deductibles. The idea is that by staying proactive with your health, you can catch issues early and avoid more serious problems down the line.
When people stay healthier, it can mean lower costs over time. For instance, catching diabetes early and starting treatment can prevent more expensive and severe issues later on.
ACA is designed to help everyone enjoy better quality and more affordable healthcare in the years to come.
Lowered Medicare Cost for Seniors:
The ACA has significantly cut costs for seniors on Medicare. Since it was enacted, it’s saved seniors over $20 billion on prescription drugs and provided free preventive services like cancer screenings and wellness visits.
One major change was closing the Medicare Part D coverage gap, or “donut hole,” which used to force seniors to cover the full cost of their prescriptions after reaching a certain spending limit until catastrophic coverage kicked in. Before this fix, about 5 million Medicare beneficiaries were stuck in this gap.
Coverage of Essential Health Benefits:
Obamacare requires all health insurance plans to cover a set of essential health benefits. These include:
Preventive and wellness services (like annual check-ups and vaccinations)
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitation services
- Laboratory services
- Pediatric care
These benefits ensure that you receive comprehensive care without additional out-of-pocket costs for these crucial services.
No Lifetime or Annual Limits
Under Obamacare, health insurance plans are prohibited from setting lifetime or annual limits on essential health benefits. This means that if you have a chronic illness or require extensive medical care, you won’t have to worry about hitting a cap on your insurance coverage.
Access to Health Insurance Marketplaces
Obamacare established health insurance marketplaces, also known as exchanges, where you can compare different health insurance plans and find the one that best fits your needs and budget. These marketplaces make it easier to understand your options and ensure you’re getting a plan that works for you.
Young Adult Coverage
The ACA allows young adults to stay on their parent’s health insurance plan until they turn 26. This provision helps young adults transition from school to the workforce without worrying about losing their health coverage.
Support for Small Businesses
Obamacare offers tax credits to small businesses that provide health insurance to their employees. This makes it easier for small businesses to offer competitive benefits and support the health and well-being of their workforce.
Conclusion
Enrolling in Obamacare provides numerous benefits that can improve your health, protect your finances, and ensure you have access to comprehensive care.
Whether you’re looking for affordable insurance, coverage for pre-existing conditions, or preventive services, the ACA offers valuable protections and options. Take advantage of these benefits and secure your health and future. Get your Obamacare coverage with us today.
