Additional Provisions and Fees of Obamacare 2014


ObamaCare imposes a new requirement on all U.S. citizens and legal residents to obtain government-approved health insurance. For most Americans this will mean they are required to carry health insurance or run the risk of paying fines under Obamacare starting in 2014.

Here is the brief description about the Affordable Care Act, otherwise known as Obamacare:

  • If you have health coverage you like, you can keep it. Children under 26 can stay on a parent’s health insurance plan.
  • Pre-existing conditions are covered. Starting in 2014, Obamacare will make it illegal for insurance companies to deny coverage to people with pre-existing conditions. Pregnancy will no longer be considered a pre existing condition and it will be possible to get maternity insurance whether you’re already pregnant or not. That has not been the case until now. Many insurance providers would deny coverage to people with pre existing conditions.
  • Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. Insurance policies must cover these benefits in order to be certified and offered in the Health Insurance Marketplace, and all Medicaid state plans must cover these services by 2014.
  • Depending on your family size and income, you may get lower costs on monthly premiums and out-of-pocket costs.
  • If you don’t have coverage in 2014 you’ll have to pay a fee, or a percentage of family income. In 2014, the penalty will be $95 per adult in an uninsured household, increasing to $325 in 2015, then to $695 in 2016, after which it will increase annually in line with consumer inflation. For uninsured children, the fine will be half the amount applied to uninsured adults. If greater, households pay 1 percent of their income in 2014, 2 percent in 2015, and 2.5 percent in 2016 and thereafter in lieu of the flat per person fee.
  • If you have coverage and want to explore Marketplace plans, you can. But if you have an offer of insurance from an employer, you may not be able to get lower costs on Marketplace insurance based on your income. It depends on whether the insurance you’re offered is considered affordable and meets minimum standards.
  • Medicare isn’t part of the Marketplace. If you have Medicare, keep it.
  • Marketplace open enrollment started October 1, 2013. It closes March 31, 2014. It’s important to remember that you DON’T HAVE TO buy your health insurance through your state healthcare marketplaces. There are still many private insurers out there who will provide coverage at competitive rates, sometimes cheaper, so it’s important to shop around. If you buy private insurance, you’re not eligible for subsidies or tax breaks, but you may have a wider variety of insurers with different pricing to choose from.
Best regards
und viele Grüße aus Charlotte
Reinhard von Hennigs