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Contents tagged with Affordable Care Act

What Makes Obamacare Affordable?

Posted Sep 18, 2017
By Jenifer Dorsey

What Makes Obamacare Affordable?

If health insurance rates keep going up, when does coverage cease to be affordable? The answer to that question depends on a number of factors and can be fairly subjective. However, we can look at how the Affordable Care Act (ACA) defines affordability for guidance.

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Infographic: The Obamacare Coverage Gap Map

Posted Sep 05, 2017
By Jenifer Dorsey

Infographic: The Obamacare Coverage Gap Map

The annual open enrollment period for Obamacare plans (i.e. individual major medical insurance) sold on and away from the state-based and federally facilitated health insurance exchanges begins November 1, 2017. Again, this year, the trend is toward fewer carriers participating in the state-based and federally facilitated health insurance exchanges established under the Affordable Care Act.[1]

Continue Reading: Infographic: The Obamacare Coverage Gap Map


Is There Still Obamacare? What’s Happening with Healthcare?

Posted Sep 01, 2017
By Jenifer Dorsey

Is There Still Obamacare? What’s Happening with Healthcare?

Calls to repeal and replace Obamacare seem quieter these days, but the discussion is not necessarily over. In the meantime, we are approaching the Affordable Care Act’s annual open enrollment period—or at least the time of year during which we’ve come to expect it.

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Pre-Verification Required

Posted Aug 25, 2017
By Jenifer Dorsey

Pre-Verification Required

Need an Obamacare plan right now? Be ready to prove you qualify.

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Lost My Job. Lost My Health Insurance. Now What?

Posted Jul 27, 2017
By Jenifer Dorsey

Lost My Job. Lost My Health Insurance. Now What?

Sometimes life happens, for better or worse. The Obamacare plan you chose no longer makes sense for you and your growing family. You lose access to your employer-sponsored health insurance. You move out of your current plan’s coverage area to pursue a new opportunity.

Continue Reading: Lost My Job. Lost My Health Insurance. Now What?


Why Hospital Indemnity?

Posted Jun 15, 2017
By Jenifer Dorsey

Why Hospital Indemnity?

Health insurance deductibles tend to be something we think little about until medical bills start showing up. At that point, even those who find their monthly premium payments somewhat manageable may feel financially strained as they pay for healthcare fully out of pocket until they meet their plan deductible.

Continue Reading: Why Hospital Indemnity?


A Healthcare Bill in the Senate, Birth Control Back in the Headlines

Posted Jun 08, 2017
By Jenifer Dorsey

A Healthcare Bill in the Senate, Birth Control Back in the Headlines

Open enrollment for 2018 individual health insurance plans may not begin until November 1, 2017, but insurers need to file premium rates for Obamacare exchange plans by June 21[1]. But under what context are they filing them: a continuation of Obamacare or something else?

Continue Reading: A Healthcare Bill in the Senate, Birth Control Back in the Headlines


Women’s Health—Preventive Care at Every Age, Benefits That Help

Posted May 15, 2017
By Jenifer Dorsey

Women’s Health—Preventive Care at Every Age, Benefits That Help

 

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4 Ways Obamacare Expands Mental Health and Substance Use Coverage

Posted May 08, 2017
By Jenifer Dorsey

4 Ways Obamacare Expands Mental Health and Substance Use Coverage

 

Mental health illnesses and substance use disorders touch many lives, both directly and indirectly. An estimated 1 in 17 Americans face a serious mental health illness, and more than 1 in 7 Americans ages 12 and older have a substance abuse problem.1,2  

Recovery and access to care play an important role in these lives. According to the Substance Abuse and Mental Health Services Administration, in recent years, a focus on recovery has “signaled a dramatic shift in the expectation for positive outcomes for individuals who experience mental and/or substance use conditions.”3 SAMHSA goes on to state, “Recovery is built on access to evidence-based clinical treatment and recovery support services for all populations.” 

It is said that Obamacare is helping expand needed mental health and substance abuse coverage to those who need it. At MentalHealth.gov, the U.S. Department of Health and Human Services, “The Affordable Care Act offers one of the largest expansions of mental health and substance use disorder coverage in a generation.”4

Here are four ways the healthcare reform law is working to help provide more Americans with access to mental health and substance use coverage:

1. Guaranteed issues health insurance

Health insurance companies can no longer deny you major medical insurance coverage or charge you more based on preexisting conditions; this includes mental illness and substance abuse. 

2. Essential health benefits

Most individual and small employer health insurance plans must cover mental health and substance use disorder services as well as rehabilitative and habilitative services. 

These services are among the Affordable Care Act’s 10 essential health benefits, which major medical health insurance plans offered on and away from the state-based and federally facilitated exchanges. 

Essential health benefits cannot be subject to annual or lifetime dollar limits.

3. Free preventive care

Major medical health insurance plans sold on and away from the state-based and federally facilitated exchanges must include certain free preventive services. That means insured individuals can access them for no additional cost beyond their monthly premium—even if they haven’t met their deductible. 

Mental health and substance abuse services included in this free preventive care are as follows: 

  • For adults5,6: alcohol misuse screening and counseling, tobacco use screening and cessation interventions for tobacco users—including expanded counseling for pregnant women, and depression screening
  • For adolescents7: alcohol and drug use assessments, depression screening for adolescents

4. Parity protections

Building on the Mental Health Parity and Addiction Equity Act of 2008, major medical insurance plans sold on and away from the state-based and federally facilitated exchanges must provide certain parity protections. 

This generally means that limits applied to mental health and substance abuse services cannot be more restrictive than those applied to medical and surgical services.8 This includes financial, treatment and care management limits. 

As part of the healthcare reform law, these parity protections are extended to an estimated 62 million Americans.

Mental health, substance use and other types of health insurance

Medicaid, the Children’s Health Insurance Program (CHIP), and Medicare all cover some mental health services. If you are insured through one of these programs, it is important to check with that program to confirm specific benefits.

If you have questions about mental health and substance use disorder benefits covered by your health plan, contact your insurance company. It is always important to check with your health insurance company to verify your health insurance benefits, whether you have job-based coverage, enroll in a plan sold through your state’s state-based or federally facilitated exchange, or purchase a health plan in the private marketplace.

 

Originally posted September 29, 2015


References

HealthCare.gov. “Mental Health & Substance Abuse Coverage.” https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/

Substance Abuse and Mental Health Services Administration. “National Recovery Month.” http://www.recoverymonth.gov/

U.S. Department of Health & Human Services. “Health Insurance and Mental Health Services.” http://www.mentalhealth.gov/get-help/health-insurance/

1 Miller, Alan B. “Obamacare Has Been a Huge Help for Mental Health Care.” CNBC. Jan. 26, 2015. http://www.cnbc.com/2015/01/26/obamacare-has-been-a-huge-help-for-mental-health-care-commentary.html

2 CASAColumbia. “Addiction: The Unmet Need.” Last updated July 15, 2015. http://www.casacolumbia.org/about

3 Substance Abuse and Mental Health Services Administration. “Recovery and Support.” Last updated Oct. 29, 2014. http://www.samhsa.gov/recovery

4 U.S. Department of Health & Human Services. “Health Insurance and Mental Health Services.” http://www.mentalhealth.gov/get-help/health-insurance/

5 HealthCare.gov. “Preventive Health Services for Women.” https://www.healthcare.gov/preventive-care-benefits/women/

6 HealthCare.gov. “Preventive Health Services for Adults.” https://www.healthcare.gov/preventive-care-benefits/adults/

7 HealthCare.gov. “Preventive Health Services for Children.” https://www.healthcare.gov/preventive-care-benefits/children/

8 HealthCare.gov. “Mental Health & Substance Abuse Coverage.” https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/

About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual specialty benefit products, including disability, supplemental health, pet, and group life insurance through its subsidiaries since 1980. The IHC Group owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), and IHC Specialty Benefits, Inc., a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers..

About IHC Specialty Benefits, Inc.
IHC Specialty Benefits, Inc. (IHC SB) is a technology-driven, full-service marketing and distribution company that focuses on small employer and individual consumer products through general agents, telebrokerage, advisor centers, and private-label arrangements. IHC SB conducts business under the following brands: Healthedeals.com; Health eDeals Advisors; Aspira A Mas; and PetPlace.com. For more information about IHC SB visit http://www.ihcgroup.com/companies.

Continue Reading: 4 Ways Obamacare Expands Mental Health and Substance Use Coverage


Are Immunizations Free Under Obamacare?

Posted Apr 24, 2017
By Jenifer Dorsey

Are Immunizations Free Under Obamacare?

 

What Vaccines Are Covered By ACA Health Insurance Plans

Immunization vaccines are considered an important part of preventive healthcare for children and adults.[1] As such, the Affordable Care Act requires private group and individual health insurance plans to include vaccines among covered preventive services—covered preventive services are offered to insured adults and children at no additional cost beyond their monthly plan premium.

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ACA-covered immunization vaccines

The Advisory Committee on Immunization Practices recommended which immunization vaccines for adults and children should be among Obamacare’s covered preventive services.[2] These vaccines include the following and apply to all major medical plans effective on or after Sept. 23, 2010, whether they are purchased in the private market or from a state-based or federally facilitated health insurance exchange:

Adults[3]

  • Diphtheria
  • Hepatitis A
  • Hepatitis B
  • Herpes zoster
  • Human papillomavirus (HPV)
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Mumps
  • Pertussis (whooping cough)
  • Pneumococcal
  • Rubella
  • Tetanus
  • Varicella (chickenpox)

2016 recommended immunizations for adults, by age (ages 19 and older)

Children[4]

  • Diphtheria, tetanus, pertussis (whooping cough)
  • Haemophilus influenzae type B
  • Hepatitis A
  • Hepatitis B
  • Human papillomavirus (PVU)
  • Inactivated poliovirus
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Pneumococcal
  • Rotavirus
  • Varicella (chickenpox)

2016 childhood immunization schedule (birth through 6 years old)

2016 adolescent immunization schedule (7 through 18 years old)

Immunizations covered by Medicare, Medicaid, CHIP

If you and your family members are covered by Medicare, Medicaid, CHIP or other health insurance plans that may or may not qualify as minimum essential coverage under Obamacare, check with your plan to determine immunization benefits.

A note on ACA-covered immunization vaccines schedules, doctor recommendations

Vaccine doses, the recommended age at which they are received and the populations that should receive them may vary. Your healthcare provider will suggest an immunization schedule appropriate for you.

Even with Obamacare’s essential health benefits and covered preventive services, health insurance benefits differ by plan. Always check with your health insurance plan to confirm your current benefits for immunizations and other healthcare. 

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Or, call the number at the top of your screen to speak with a licensed health insurance producer.

 

 

 

Originally posted September 2, 2015. Last reviewed and updated August 12, 2016.



[1] U.S. Department of Health & Human Services. “The Affordable Care Act and Immunization.” Last updated Jan. 20, 2012. http://www.hhs.gov/healthcare/facts/factsheets/2010/09/The-Affordable-Care-Act-and-Immunization.html

[2] Ibid.

[3] HealthCare.gov. “Preventive Care Benefits for Adults.” Accessed Aug. 8, 2016. https://www.healthcare.gov/preventive-care-adults/

[4] HealthCare.gov. “Preventive Care Benefits for Children.” Accessed Aug. 8, 2016. https://www.healthcare.gov/preventive-care-children/

These products are not qualifying health coverage (“Minimum Essential Coverage”) that satisfies the health coverage requirement of the Affordable Care Act. If you don't have Minimum Essential Coverage, you may owe an additional payment with your taxes. The termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period. These products may include a pre-existing condition exclusion provision.

About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual specialty benefit products, including disability, supplemental health, pet, and group life insurance through its subsidiaries since 1980. The IHC Group owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), and IHC Specialty Benefits, Inc., a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers.

About IHC Specialty Benefits
IHC Specialty Benefits, Inc. (IHC SB) is a technology-driven, full-service marketing and distribution company that focuses on small employer and individual consumer products through general agents, telebrokerage, advisor centers, and private-label arrangements. IHC SB conducts business under the following brands: Healthedeals.com; Health eDeals Advisors; Aspira A Mas; and PetPlace.com. For more information about IHC SB visit http://www.ihcgroup.com/companies.

Continue Reading: Are Immunizations Free Under Obamacare?

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