Single or Expectant Parents
The Affordable Care Act (ACA) - also called Obamacare - is a new law helping more Americans get health insurance. This guide will help you understand how it's affecting single and expectant parents.
And if you're overwhelmed, don't worry! Just call or email us. We're trained and authorized to help.
THE LAW IS MAKING IT EASIER FOR KIDS TO GET INSURED
See if you qualify for discounted insurance.
Under the new law, you might qualify for a tax subsidy to lower your health insurance cost. A tax subsidy is money the government will pay directly to your private insurance company to make your plan affordable. The amount you get, if any, depends on your household income and family size.
Medicaid is expanding to cover more people.
The income cut-off for Medicaid used to be 100% Federal Poverty Level (FPL), but now it has been raised to 138% FPL starting in 2014. Medicaid varies by state, and not all states chose to expand the program. See if your children qualify for Medicaid, even if you don't.
See if your kids can get CHIP.
Since 1997, the Children's Health Insurance Program (CHIP) has been providing insurance to children whose families make too much money for Medicaid but still require financial assistance toward health insurance. CHIP programs vary by state.
You're required to have health insurance, or pay a penalty.
Starting in 2014, most of us are required to have health insurance or pay a penalty. Qualified health insurance could be job-based coverage, private health insurance, Medicaid, Medicare, or other goverment-sponsored plan.
BENEFITS ARE BETTER
You can't be turned you down because of a pre-existing condition. No, really.
You and your children are guaranteed acceptance no matter what, even if you have a pre-existing condition or if you are pregnant. And no insurance company can drop you just because you get sick.
You can't be charged extra premium for pre-existing conditions.
All pre-existing conditions are covered. Insurance companies can longer penalize your child for having pre-existing conditions. That includes pregnancy.
All plans cover Essential Health Benefits with no yearly or lifetime limits.
All plans must include coverage for certain benefits with no limits so you can never run out of insurance for core care. Essential Health Benefits includes doctor office visits, hospitalization, prescriptions, maternity, and more.
Dental and vision care for children under age 19 is included now.
Is your child overdue for a dental cleaning? Is he squinting to see the board at school? Dental and vision care for children is included in all new health plans.
You and your children get free checkups.
Health insurance isn't just for when you get sick - it's also for keeping you well so you don't get sick. All new plans include free preventive care for you and your kids for things like checkups, tests, screenings, and immunizations.
CHANGES IN MATERNITY COVERAGE
Pregnancy is not a pre-existing condition and it's always covered. Always.
Insurance companies used to turn you down if you were pregnant, but they can't anymore. And maternity coverage is always included, even if you're pregnant now. But remember: you must enroll during Open Enrollment.
Your new baby might actually lower your health insurance costs.
Remember that tax subsidies are based on household income and family size, and your family size is growing. A tax subsidy is the amount the government pays directly to your insurance company to keep your health insurance affordable.
What if the baby is born after Open Enrollment ends?
No problem. Birth is a qualifying event, which allows you to enroll in a new health plan at an odd time of the year. It's good to plan ahead, so you can make your plan choice right after the baby is born.
THE POWER OF CHOICE
You can choose your insurance company.
Even if you qualify for a tax subsidy, you can still choose your insurance company. Obamacare is not insured by the government. It a law that helps pay your private health insurance to make it more affordable based on your family size and household income. Pick your insurance company from the ones available in your area.
You choose your benefits.
You'll choose from four plans: Platinum, Gold, Silver, or Bronze. And if you're under 30, you'll have a fifth "catastrophic plan" choice. The plans are the same whether you qualify for a subsidy or not. Use our Plan Guide to help you decide.
SOMETHING TO THINK ABOUT
The benefits are the same whether you accept a tax subsidy or not.
The law says that plans have to be identical on and off-exchange. So that means that you won't be giving up any benefits if you accept government money to lower your healthcare costs.
You might notice fewer doctor choices under ACA.
There's always a catch, isn't there? For on-exchange plans - where the government subsidies your costs if you qualify - the provider network is smaller for most plans. That's not the case every time, though. So if you have a favorite OB-GYN, pediatrician, or other provider, you might want to make sure they accept the insurance plan you are considering before you enroll.
If you're pregnant, you might want to consider a better benefit plan.
You already know that you're going to have a lot of doctor visits and probably a hospital stay. So you might want to consider a better benefit plan this year - like Platinum or Gold - if the premium is affordable for you.