Answers to Common Insurance Questions

There are several major changes to health care insurance, many of which will go into effect on January 1, 2014.

1. The elimination of “pre-existing conditions” is a method that insurance companies use to keep Americans from obtaining decent health care insurance. Now, no matter what your current or previous health conditions are or were, you are virtually guaranteed to get the same coverage as your healthy neighbor. This also opens up the possibility of changing insurance companies if the rates go too high for the market, just like you can do with your auto insurance. No longer are you forced to endure uncompetitive premiums because of the fear of your pre-existing conditions not being covered or having a two-year waiting period before they would be. The PPACA has virtually eliminated that situation.
2. Elimination of the “lifetime maximum” coverage amount that used to be built into every major medical insurance plan. Now, if a serious disease or injury strikes you or your family, you will no longer be potentially threatened with losing your life savings or even your home in order to pay for extensive and ongoing medical care for that disease or injury. Gone is the clause where they limit the amount they will pay over your “lifetime” as an insured with that health insurance company.
3. Federal funding for low-income individuals and families. For those individuals and families whose cumulative earnings are below specific multiples of the Federal Poverty Level, there are tax credits and cost-sharing options available to reduce or even eliminate healthcare insurance premiums. Individuals with incomes between 100 and 400 percent of the federal poverty level (FPL) may be eligible for federal premium tax credits to help pay for private health insurance through the Marketplace.  Individuals with incomes between 100 and 250 percent of the federal poverty level may also be eligible for additional cost-sharing reductions to help lower their out-of-pocket expenses (e.g., co-pays and deductibles). Call or email The Insurance Pedaler for help in obtaining these subsidized plans through the Federally-Facilitated Marketplace (FFM). $11,770 is the poverty guideline level for an individual between 19 and 64, and $23,550 is the guideline for a family of 4. Call or email The Insurance Pedaler for more information on whether you or your family may be eligible for a premium reduction or cost-sharing based on these numbers and the multiples mentioned above.
4. ACA-qualified major medical insurance must meet strict guidelines on specific coverages. When you are comparing plans now, gone is the worry of ending up with a stripped-down plan that will not take care of you or your family when you need it most.

Sure! Go for it! But why would you want to risk making a mistake when using a knowledgeable, experienced, and FFM-certified agent/broker like The Insurance Pedaler, which costs you nothing more than if you go it alone? [Certified by the U.S. Department of Health and Human Services.]