The Department of Health and Human Services (HHS) recently unveiled HealthCare.gov, a new website that will help central Ohio consumers and small businesses take control of their health care by offering them to new information and resources that will help them access quality, affordable health care coverage. You can find additional information on health insurance reform below, and if you have any questions please contact my office.
Can’t find the answer to your question? Contact my office directly by submitting your question here. A representative from my local office will respond to you personally.
Q. My child recently graduated from school and has no health insurance. How can I add them to my plan?
A. Six months from now, insurers will be required to allow children to stay on family policies up to the age of 26. This requirement will take effect the next time your plan comes up for renewal. Adult children who are on their parent’s plan now but who will lose that coverage when they graduate from college will have the option to rejoin their parent’s policy in the new plan year beginning 6 months from now.
This applies to all plans in the individual market, new employer plans, and existing employer plans as long as your adult child is not offered coverage through their employer. Beginning in 2014, children up to age 26 can stay on their parent’s plan even if they are offered coverage through their employer.
Q. I am on Medicare and will hit the donut hole this year in my prescription drug plan. What relief will I receive?
A. If you hit the gap in Medicare prescription drug coverage, known as the donut hole, you will receive a $250 rebate in 2010.
Beginning in 2011, seniors in the donut hole will receive a 50% discount on prescription drugs. In addition, the Medicare share of costs will increase each year so that the donut hole will be completely closed in 2020.
Q. I have a pre-existing condition. How can I get coverage this year?
A. If you have been uninsured for 6 months and have a pre-existing condition, you will gain access to health insurance through a new program, known as the high-risk pool. This program will provide affordable health insurance for individuals with a pre-existing condition until 2014, when insurance companies can no longer deny you coverage based on your health.
Q. My child has a pre-existing condition. Can I get her coverage?
A. Yes, effective 6 months from now it will be illegal for health insurance companies that cover children under 19 years of age to deny coverage based on a pre-existing condition. This applies to all new employer plans, news plans in the individual market and existing employer plans.
Q. I own a small business with only 12 employees. Will I be given assistance in offering health insurance coverage and will I be penalized if I cannot afford it?
A. You will not be penalized. Employers with less than 50 full-time employees will not be penalized for not offering health insurance to their employees. However, if you would like to offer insurance, you will be provided tax credits to help with the cost. The tax credit, which is effective immediately, can cover up to 35% of the premiums a small business pays to cover its workers. In 2014, the rate will increase to 50%.
To qualify for the credit, your business must have less than the equivalent of 25 full-time workers (so a firm with less than 50 half-time workers would be eligible), pay average annual wages below $50,000 per employee, and cover at least 50% of the cost of coverage for their employees.
Non-profit organizations are eligible for a 25% tax credit this year that will increase to 35% in 2014.
Q. When does free preventive care start and will it affect my plan?
A. In 6 months, all new group health plans and new plans in the individual market must provide coverage for preventive services. Recommended prevention and vaccination services will be covered without any deductibles or copayments. Seniors enrolled in Medicare will also no longer have to pay for proven preventive services such as flu shots or prostate cancer screenings.
Q. My insurance company just withdrew my coverage, claiming I had a previous illness. Can I fight back?
A. Effective 6 months from now, insurance companies will be prohibited from dropping your coverage when you get sick. This will apply to all new and existing plans.
In addition, insurers will no longer be able to place lifetime limits on what they will pay for your medical care and can only apply restricted annual benefit limits.
