All of the above are common questions being asked as the implementation for healthcare exchanges draws closer. The Affordable Care Act prohibits health insurance companies from denying coverage due to a pre-existing medical condition. Previously, those with a past history of certain medical problems were denied approval for coverage right out of the gate, contributing to the high numbers of Americans without health insurance. Now that insurance companies must factor in the costs associated with coverage for individuals with pre-existing conditions (as well as other mandates in the Affordable Care Act), premiums are expected to rise for the general population in order to compensate for the changes. Over time, however, it’s expected that costs will go down. For those individuals whose incomes are less than 400% of the federal poverty level, they are likely to pay less on the premium because of the government subsidies on the premium.
Consumers will have the chance to select a plan in the bronze, silver, gold or platinum category, but there are 2% to 9.5% caps for the premiums based on the individual’s income plan. Anyone younger than 30 years old is also eligible to choose what’s known as a basic plan.
Final state details are still being hammered out with regard to prescriptions, as each state must select a “benchmark plan” that will establish a guideline for details related to particular services, including prescription drugs. Certain prescriptions will be covered under your healthcare plans, and others may be associated with a co-pay. To learn more about your options, set up a meeting with your health insurance agent to prepare for the live opening of Covered California, the state’s health insurance exchange.