The law, also known as health care reform, went into effect in March 2010. The name Affordable Care Act is used to refer to the final, amended version of the law. The goal of the Affordable Care Act is to make health insurance available to everyone, regardless of medical history or ability to pay.
Employer coverage is considered affordable when the cost for “you only” coverage is less than 9.5% of your income. If your employer offers coverage that is considered affordable and meets minimum standard coverage requirements, and you choose to buy insurance through a marketplace, you may not qualify for financial help.
An insurance program that provides health insurance to low-income children. In some states, it also provides for pregnant women in families who don't qualify for Medicaid and can't afford private health insurance.
The deductible is what you pay out of pocket before your insurance starts paying its share of your costs. How the deductible works depends on the plan you choose.
A package of state-mandated benefits that insurance companies are required to offer as part of insurance purchased through a marketplace. Essential health benefits must include items and services within at least the following 10 categories:
A requirement that most Americans obtain health insurance by January 1, 2014. If you don't have health insurance in 2014, you'll pay a penalty equal to the greater of $95 per adult and $47.50 per child (up to $285 per family), or 1% of your family income. The penalty will increase significantly in 2015 and 2016:
There are exceptions to the individual mandate. See "You Must Have Insurance" for information.
An online marketplace, or “exchange”, is a website where health insurance companies come together to give you a place to shop for health insurance. That way you have one place to compare options for private health insurance side by side.
A federal program that provides health and long-term care coverage to certain categories of low-income Americans.
A federal program that provides health insurance coverage to people who are:
Your gross income is how much money you make before taxes. You then subtract any “deductions” you have to get your adjusted gross income. Some deductions, such as tax-free interest, are then added back in to get your modified adjusted gross income. Your modified adjusted gross income is used to determine your eligibility for financial help to buy insurance in a state or federal marketplace.
The amount you and your covered family members must pay out of your own pocket for medical services and prescription drugs. Generally, your out-of-pocket costs include the deductible, copayments, and the portion of any eligible expenses that insurance doesn't pay. It doesn't include the amounts you pay in premiums.
The most you and your covered family members would have to pay in a year for medical and prescription drug costs. Generally, it includes the deductible, applicable copayments, and the portion of any eligible expenses that insurance doesn't pay. It doesn't include amounts you pay for premiums.
Services including tests and immunizations that can help you avoid illness and improve your health. Under the Affordable Care Act, preventive care services recommended by the U.S. Preventive Services Task Force must be covered at no cost to you. That means you won't pay anything for these services as long as you get them from a doctor, lab, or other provider who is part of your health plan's network