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Already Insured? What You Need To Know About Obamacare

Michelle Bergmann |
October 1, 2013 | 7:35 p.m. PDT

Staff Reporter

Healthcare policy changes affect almost all Americans, screenshotted photo by Sara Newman
Healthcare policy changes affect almost all Americans, screenshotted photo by Sara Newman
With the launch of Obamacare, millions of America's uninsured are flocking to Healthcare.gov to register for new health insurance, while those who are already insured carry on with their daily activities, relatively unaffected.

But, before getting too comfortable, people should consider how Obamacare will affect them in less obvious ways.

Below is a cheat sheet on what you need to know if you were previously insured, but first a message from your health care provider. 

“Don’t panic, take your time, there is time. Because people have gotten the wrong message,” said Mike, a health advisor with Anthem Blue Cross. 

I heard that if you signed up for health insurance after March 23, 2010 then you have to sign up for Obamacare. Is this true?

Yes, unless your plan is grandfathered you will in fact need to sign up for Obamacare. According to the grandfathered law, if you joined a health plan after March 23rd of 2010, but the plan was in existence on March 23rd of 2010 your plan may be grandfathered and you do not to sign up for new health insurance. But, if you signed up for a new plan after March 23rd of 2010 you will need to sign up for Obamacare.

Great. How long do I have to figure this out?

Open enrollment lasts until March 31st. But coverage can begin starting January 1st. 

Well, can I at least stay on my parent’s plan since I'm under 26?

Yes, even if you currently in school or employed.

I already pay for health insurance, so what do I get out of this?

Under the new Affordable Care Act there will be a number of new policies in place to help consumers get the most out of health insurance companies. 

The Rate Review requires health insurance companies to justify rate increases of 10 percent or more.

The 80/20 rule—more formally known as the medical loss ratio— requires 80 percent of the money from member premiums to be put towards better quality health care by the insurance companies. 

Alas, you might be able to get lower costs on coverage, then your current plan, by visiting The Marketplace.

What if I have job-based insurance? 

If you have job-based insurance you can either keep it or visit the marketplace to make a change if you so prefer.

Well, this plan sounds alright to me, so what's the catch?

If you are under a grandfathered plan, you may have to pay a higher rate than what you pay now, depending on your current health insurance plan.

Will this affect my insurance company?

Maybe. Mike of Anthem Blue Cross says that there is no current data to provide answers since this is the first time this type of law has passed (at least for right now). For Mike, it's not worth playing the guessing game.

“There are a lot of guesses being made and so many variables. We could have claims through the roof where we have to pay a lot of money, or the claims might be low and not affect us at all,” said Mike of Anthem Blue Cross. 

What if my insurance company drops my coverage?

You can demand an explanation or an internal review from your insurance company if they drop your coverage. Insurers need to explain why they will not cover a claim, deny coverage or conduct an internal review. Plus there is always the option of seeking out a third party to review the unpaid claims or dropped coverage. 

Wait! I need more information.

Visit HealthCare.gov, a seemingly user friendly site, President Obama describes it as easy as buying a "plane ticket on kayak or a TV on Amazon."

For now, though, the site is experiencing some technical difficulties due to unexpectedly high visitor traffic—more than a million people logged on by 7am EST on opening day.

With this in mind it may be worth waiting a few days before you jump on the phone or online to avoid the crowds. Remember, you have time.

Reach Staff Reporter Michelle Bergmann here.



 

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