Affordable Care Act insurance plans revealed

September 25, 2013 9:05:37 PM PDT
Beginning Jan. 1, 2014 all Americans without health insurance must get it.

Most Californians who have medical insurance haven't made changes to their policies in years. But when annual open-enrollment starts in the next couple weeks, everyone's plan will look a little different.

Wade Overgaard is with Kaiser Permanente, one of the insurance companies providing coverage in California. He said the Affordable Care Act "will standardize the market."

Kaiser Permanente insures nearly 9 million Californians. Most of its patients get their insurance from their employers.

Beginning in January, everyone will have to choose a new plan based on the government's uniform insurance categories. The health plans are categorized as bronze, silver, gold and platinum. With these new plans, your costs may go up, or down. Depending on which plan you choose, your medical insurance will cover anywhere from 60-90 percent of your total medical costs.

"So it's much like you do in other industries, where you are looking at a car, car insurance, and you're asking yourself what kind of deductible to I want to pay," Overgaard said.

Those deductibles have been standardized. They range from $0-$5,000, depending on the level of service you choose.

Regardless of your plan, most people won't see much of a change in their medical coverage from what they have now.

"I don't believe for us there will be any case where people will have less benefits," Overgaard said.

But there are other changes mandated by the affordable care act. Insurance companies can no longer deny coverage for pre-existing conditions.

The act makes it illegal for health insurance companies to arbitrarily cancel your insurance if you get sick and they can raise your rates if you do get sick. Insurance companies are now accountable for rate increases.

The law also protects your choice of doctors and ends lifetime and yearly dollar limits of essential health benefits.

The Affordable Care Act also guarantees your right to appeal any denial of care.

John Hedberg is with Blue Shield of California, he says "benefits will get better, generally."

Blue Shield of California insures roughly 3 million people.

"Part of the insurance plans now is that all preventive care is covered and that includes adults and children," Hedberg said.

For many people, medical expenses will likely go down. That's because the Affordable Care Act requires all policies offer preventive care at no additional cost to consumers. That covers everything from blood pressure and depression screenings, to immunization vaccines, obesity screening, and mammograms. The law also expands preventative coverage for children, as well.

The federal government has created a comprehensive list of what insurance companies must cover as preventive care. If your employer does not offer health insurance you can get coverage through the state's insurance exchange just go to www.coveredca.com.

Written and produced by Ken Miguel


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