THE PATIENT PROTECTION AND AFFORDABLE CARE ACT HAVE
THE PATIENT PROTECTION AND AFFORDABLE CARE ACT
HAVE YOU HEARD? Th e. N ew He m a r lth o f e L R e e H h t l a r a C aw OBAMACA RE Community Health Initiative of Kern County
HAVE YOU HEARD? The Patient Protection and Affordable Care Act Community Health Initiative of Kern County
HAVE YOU HEARD? The Patient Protection and Affordable Care Act Community Health Initiative of Kern County
HAVE YOU HEARD? The Patient Protection and Affordable Care Act Community Health Initiative of Kern County
PATIENT PROTECTIONS
PATIENT PROTECTION 1. 2. 3. 4. 5. Cannot be denied coverage due to a preexisting condition. Able to maintain coverage for young adults. Ends lifetime limits on health coverage. Restricts or eliminates annual limits on coverage Provides preventive services at no cost. § Expanded preventive services are offered to women Community Health Initiative of Kern County
PATIENT PROTECTION 6. 7. 8. 9. 10. Does not allow premium increases without justification. The majority of the expenses must go towards medical costs. Cannot cancel coverage due to errors on the application. Requires an easy to understand explanation of benefits and coverage. Essential benefits AND MORE! Community Health Initiative of Kern County
INDIVIDUAL MANDATE
THE INDIVIDUAL MANDATE Most U. S. citizens and legal residents must have health insurance or pay a fine. Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE 2014 2015 2016 For every uninsured adult $95 $325 $695 For every uninsured child $47. 50 $162. 50 $347. 50 1% 2% 2. 5% Or a percentage of your income, whichever is greater Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE Who is exempt? Persons with a religious objection Undocumented immigrants Incarcerated persons Members of Indian Tribes If your household income is so low that you are not required to file an income tax return If buying health insurance is too expensive Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE There are options! Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE My employer offers me health insurance. Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE My employer does NOT offer me health insurance and My total household income is less than 138% of the Federal Poverty Level Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE My employer does NOT offer me health insurance and My total household income is less than 400% of the Federal Poverty Level Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE My employer does NOT offer me health insurance and My total household income is more than 400% of the Federal Poverty Level Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE Who is exempt? Persons with a religious objection Undocumented immigrants Incarcerated persons Members of Indian Tribes If your household income is so low that you are not required to file an income tax return If buying health insurance is too expensive Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE My employer offers me health insurance. Coverage must be: 1. Affordable 2. Adequate Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE My employer offers me health insurance but the coverage is NOT ADEQUATE. (on average, it pays less than 60% of medical costs) Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE My employer offers me health insurance but the coverage is NOT AFFORDABLE. (I have to pay more than 9. 5% of my income in premiums) Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE Your options: 1. Employer sponsored health insurance 2. Medi-Cal 3. Covered California with Premium Assistance 4. Covered California without Premium Assistance Enrollment closes March 31 st, 2014 Community Health Initiative of Kern County
WE’RE HERE TO HELP! 661 -632 -5018 Community Health Initiative of Kern County
EXPANDED PREVENTIVE SERVICES FOR WOMEN ü ü ü ü ü Anemia screening Breast Cancer Genetic Test Counseling Breast Cancer Mammography screenings Cervical Cancer screening Contraception Domestic and interpersonal violence screening Gestational diabetes screening HIV screening and counseling Osteoporosis screening Tobacco Use screening and intervention Community Health Initiative of Kern County
ESSENTIAL HEALTH BENEFITS ü ü ü Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services including behavioral health treatment Prescription drugs Community Health Initiative of Kern County
ESSENTIAL HEALTH BENEFITS ü ü Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services including: § § Oral Care Vision Care Community Health Initiative of Kern County
MEDI-CAL Family Size 1 2 4 7 Adults (138%) $15, 971 $21, 559 $32, 582 $47, 361 Children (250%) $28, 725 $38, 775 $58, 600 $89, 025 Community Health Initiative of Kern County
COVERED CA WITH PREMIUM ASSISTANCE Family Size 1 2 4 7 Household Income up to: $45, 960 $62, 040 $94, 200 $142, 440 Community Health Initiative of Kern County
COVERED CA WITHOUT PREMIUM ASSISTANCE Family Size 1 2 4 7 Household Income Greater than: $45, 961 $62, 041 $94, 201 $142, 441 Community Health Initiative of Kern County
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