Health Insurance Spotlight
As the Affordable Care Act (also known as Obamacare) and all of its policy changes are implemented on January 1, 2014, many people are left wondering how they and their families will be impacted. Regardless of your current carrier or policy, it is likely that your insurance coverage is going to change. We’ve summarized four different insurance scenarios and the changes you may see in 2014 under those carriers. Because everyone’s situation is unique, the most important thing you can do is talk to your provider, insurance carrier, or your employer to become informed on your individual policy.
Employer Group Plans
Employers with fewer than 50 employees may still offer group insurance health plans, however, they are not obligated to do so. On the other hand, employers with more than 50 employees are required to offer affordable health insurance. Either way, it is possible that your group plan will have changes in 2014. You may find that your insurance carrier could change because employers are also shopping for the best price. Your premium, deductible and copayments may also change. For many employers, health insurance premiums plus new taxes on insurance are raising the costs and in most cases, employers have no choice but to pass some of this expense onto the employees. Another thing to watch for are your “essential benefits,” which are items that must be included in all new insurance policies, so you may see changes in what is and what is not covered. If there is a medical treatment that is important to you, check your essential benefits or call your carrier to find out if it is covered. Finally, we are seeing many plans that require your deductible be fully met before the insurance company pays anything, including pharmacy prescriptions and office visits.
Individuals Looking for Insurance: Marketplace or Direct
The federal government’s intention with the Affordable Care Act is to get more people insured by allowing those who do not currently qualify for health insurance to be eligible to buy insurance plans either through the Marketplace or directly through an agent or insurance company. Open enrollment for individuals on the Marketplace started October 1, 2013 and ends March 31, 2014. All individual plans are based on medal levels: bronze, silver, gold, and platinum. Each of these levels carry the same benefits but while higher level premiums do cost more per month, they pay a higher percentage of the overall cost of expected healthcare costs. For 2014 there is a fee of $95 or 1% of your taxable income (whichever is greater) if you choose not to carry health insurance.
The good news for Medicare is that there are not significant changes occurring in 2014. However, it is currently open enrollment, so now is the time to review your coverage and decide if you will continue with your current Medicare plan or choose a different Medicare health insurance or prescription drug coverage plan. If you’d like to make any changes you’ll want to do so before the open enrollment period ends on December 7, 2013. Remember, if you have a deductible, you will be responsible for this amount on health care services that occur after January 1, 2014.
Medicaid in Michigan
Medicaid in Michigan will increase eligibility levels to 138% of the poverty level ($23,550 for a family of four). This expansion is currently scheduled to occur on April 1, 2014.
If you have questions regarding your insurance policy or how your physical therapy treatments are covered, contact your insurance provider directly, or call our insurance specialist at 616.259.5674.