Affordable Care Act Basics

Some provisions of the Affordable Care Act are already in place:

  • Cancer screenings and an annual physical have no co-pay.  Insurance now covers the full cost of these preventive services.
  • Children cannot be denied coverage because of a pre-existing condition.
  • Young adults up to age 26 can stay on their parents insurance.
  • Your insurance will continue, even if you have expensive medical costs, such as chemotherapy.  An insurance company can’t put a lifetime limit on your expenses.
  • Insurance companies must spend between 80-85% of your premium dollars on actual medical costs or pay you back the difference.
  • Seniors on Medicare are paying less for their prescriptions.
  • Insurance companies can’t deny you coverage (or stop your coverage) if you get sick.
  • Insurance companies must explain what they do and don’t cover in plain language.

What changes does the Affordable Care Act bring?

  • Insurers can’t deny anyone coverage because of an existing condition.
  • Insurance companies must sell you an insurance plan if you are able to buy one.
  • Your insurance coverage won’t stop when you reach a yearly dollar limit for coverage.
  • Insurance companies used to charge women more or people who had been sick.  That’s going to be against the law. There will also be limits on how much more they can charge based on your age or if you smoke.