What you need to know about the Affordable Care ActWhat you need to know about the Affordable Care Act
If you do not have health insurance, Health Insurance Marketplaces created under the new health care law will provide you with new options.
-Under the Affordable Care Act, everyone who lives in the U.S. legally must have health insurance or risk paying a fine. There are only a few exceptions.
-Health insurance coverage must meet minimum requirements set by the government. Charity care or a local hospital discount card does not count as minimum coverage.
-The Health Insurance Marketplace was created to help eligible persons buy affordable health insurance. Government assistance is available to people with modest incomes to help reduce the cost of insurance.
-You can no longer be denied coverage because of a pre-existing health condition.
-U.S. citizens, legal residents, or people with other types of legal status can purchase health insurance through the Marketplace. People without legal status or those who have fake or out-of-date documents cannot apply.
-Persons with DACA (Deferred Action for Childhood Arrivals) status cannot purchase insurance on the Marketplace. However, if you live in California, Illinois, New York or Massachusetts and have DACA status, you may be eligible for Medicaid.
-If you have insurance through your employer, you meet the law’s requirements. If your employer offers insurance, you may purchase a plan on the marketplace, but you are only eligible for financial assistance if your employer-sponsored insurance costs more than 9.5% of your income for an individual plan.
-The Spanish language enrollment website is CuidadoDeSalud.gov. For information you can call the National Alliance for Hispanic Health’s bilingual Su Familia helpline at 1-866-783-2645 for support Monday through Friday from 9:00 AM to 6:00 PM Eastern Time.
If you do not have health insurance, either because it is too expensive or you’ve been denied coverage in the past, the Health Insurance Marketplaces created under the new health care law provides you with new options. You can compare health insurance plans and select the best option for you and your family.
Why do I need health insurance?
No one plans to get sick or hurt, but most of us will need medical care at some point in our lives. Health insurance helps take care of you and your family’s health by protecting your family from medical costs in case of an unexpected illness or accident.
Health insurance is a contract between you and your insurance company. You buy a plan and pay monthly premiums, and the company agrees to pay part of your medical costs. There are other important benefits of having health insurance. Plans available in the Marketplace (and most other plans) provide free preventive care, like vaccines, screenings, and annual check-ups. They also cover some costs for prescription drugs.
Who can buy insurance through the Marketplace?
Many people can get health insurance through the Marketplace. To qualify, you must be a U.S. citizen or resident, or be lawfully present in the United States. You cannot currently be in prison. To learn more about the Marketplace’s immigration status requirements, click here.
Medicare enrollees may not use the Marketplace to buy supplementary coverage.
If you do not have insurance and you are not eligible for coverage in the Marketplace, call the National Alliance for Hispanic Health at 1-866-783-2645 to find out what other health care options are available for you in your area.
What is the Health Insurance Marketplace?
On the Marketplace website, you can compare health care coverage options and monthly premiums, which is the cost you pay each month for insurance coverage. You can choose the plan that fits your budget and that meets your needs.
You may qualify for extra help to pay for your health insurance: The Marketplace application determines if you are eligible for subsidies to lower the cost of your monthly premiums or out-of-pocket costs for private insurance. You can also learn if you qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
Click here for more information.
Essential health benefits are covered in the Marketplace: All plans must offer a comprehensive set of essential health benefits including doctor visits, preventive care, hospitalization, prescriptions, and more. Click here to learn more.
Pre-existing conditions will be covered: Plans are no longer able to deny you coverage or charge you more due to pre-existing health conditions, including a pregnancy or disability.
Open enrollment for 2015 insurance coverage through the Marketplace ends February 15, 2015. If you are eligible to enroll in an insurance plan, but remain uninsured after February 15, 2015, you may have to pay a fine to the government.
How do I enroll?
You can visit HealthCare.gov learn how to enroll in English. You can also access the Spanish language version of the site at: CuidadoDeSalud.gov. Help selecting plans and learning about the Marketplace in Spanish or English is also available at 1-800-318-2596.
If you prefer, you can call the National Alliance for Hispanic Health at 1-866-783-2645, and a bilingual health promotion advisor can refer you to a local organization to help you enroll, or walk you through the steps to sign up over the phone.
To search for the best health plan for you, it may also be helpful to have a list of medications and the names of your current health providers. Remember, when comparing the costs of plans, it is important to compare your “out-of-pocket” share for costs such as doctor’s visits and prescriptions, and not just your monthly insurance premium.
What if I have insurance?
If you are currently covered by insurance, you do not have to do anything. The health care law provides you with more rights and may provide you more options as well. Here is how the health care law affects your insurance coverage:
Job-based insurance: If you are happy with your current job-based insurance plan, you can keep it and will not need to make a change. If you are not happy with your plan or you think it is too expensive, you can apply for different insurance through the Marketplace, but you will only be eligible for financial assistance if an individual plan offered by your employer costs more than 9.5% of your income. If your insurance does not meet minimum standards or if your employer stops offering health insurance, click here.
Individual insurance: If you are interested in changing your individual insurance plan, you can use the Marketplace to explore your options and enroll in a new plan. Click here to learn more about when you can change plans.
Medicare or Medicaid: If you have Medicare or Medicaid, there is no change to your coverage, and you will not need to do anything. You should NOT look for a new plan on the Marketplace.
Confused or Need Help?
Call the National Alliance for Hispanic Health at
1-866-783-2645. They have bilingual certified staff available to answer your questions or put you in touch with a reputable organization near you. They can also refer you to nearby health centers, and provide you with health information.
The service is free and confidential. The Helpline is available Monday through Friday from
9:00 AM to 8:00 PM Eastern Time. At other times, or if the wait time is long, you can leave a message and a health promotion advisor will return your call.