Health insurance marketplace opens

Starting in October 2013, there’s one more way to get health coverage. It’s called the health insurance marketplace (also known as exchanges). It gives you another way to compare and buy health insurance.

All plans in the marketplace are run by health insurance companies and offer a core set of benefits called “essential health benefits.” These benefits include ER care, hospital stays, maternity and newborn care, prescription drugs and preventive care. You can choose from four levels of coverage: bronze, silver, gold and platinum.

Each level may have a few plans to choose from, with bronze having the lowest monthly premium but you pay more for your care. Platinum plans have the highest monthly premium, but you pay less when you get care.

More preventive care coverage for Medicaid

The Affordable Care Act aims to expand Medicaid to provide coverage for more Americans. States decide whether to expand their Medicaid program. If they do, the expansion means more funds for services that prevent diseases and obesity. People who qualify for Medicaid can get annual exams and vaccines for free. If you’re a woman, mammograms and other wellness checkups are covered at 100%.

 

The goal is to make it easier for people with Medicaid to take care of their health. Getting the right preventive care is tough when you have limited funds. But this care can prevent serious diseases and the need for costly care later on. The extra funds from the federal government can help Medicaid members get regular checkups and screenings at no charge.

 

Here’s what’s different

More people can qualify for Medicaid as funding from the federal government goes up. That means more people with lower income can get free preventive care.

How it impacts you

If you have Medicaid coverage, the law makes it a little easier to take care of your health. Extra federal funds can help your state cover preventive care. So annual exams, vaccines and certain screenings are free.

Do Medicaid programs in all states cover preventive care?

Yes. Each state has its own rules on Medicaid, but health care reform requires all plans to cover preventive care. Extra funds from the federal government help the states pay for it. States that choose to expand Medicaid coverage to 133% of the federal poverty can get full federal funding. With the expansion, a person under 65 who earns less than $14,500 a year can qualify for Medicaid. Or a family of up four earning less than $29,700 a year.

What does Medicaid expansion mean?

Medicaid expansion means offering health care coverage to more people with low incomes. Giving states extra funds for preventive care is part of the Medicaid expansion in health care reform.

 

Are there other changes to Medicaid benefits?

Yes. Products and services to help quit smoking will be covered starting in 2014. States can choose to cover family planning services and supplies. Coverage for prescriptions will increase.