Program Information

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What You Need To Know About The ACA

What is the Affordable Care Act?

The Affordable Care Act (ACA), also known as Obamacare, is a bill that was passed by Congress and signed into law in March of 2010.  Before, Americans did not need to have health insurance.  With the passing of this law, almost every person living in the United States will have to have health insurance.  This will begin on January 1st, 2014.

How does the ACA make healthcare better?

Coverage for those with pre-existing conditions
Individuals can no longer be denied from health insurance coverage for having pre-existing conditions!  Examples of pre-existing conditions include HIV/AIDS, diabetes, cancer, or a history of heart problems.  Additionally, insurance companies can only look at your age, where you live, and whether or not you smoke to determine how much your health plan will cost.

No lifetime limits
Your health insurance company will keep paying your healthcare needs no matter how much you need.  There is no lifetime limit and your coverage won’t run out.  Additionally, there are yearly out-of-pocket maximums for the consumer for each plan.

Increased coverage for children
Kids can stay on a parent’s healthcare plan until they are 26 years old.

Covered preventative care for women
Including breastfeeding support, birth control, and well-woman visits.

Better benefits and more preventative care
Yearly checkups are covered.  Many preventative services are also covered such as blood pressure tests, shots, and some cancer screenings.

Expanded Medicaid
Effective January 1, 2014, Medicaid in Washington State will be expanded to include individuals between the ages of 19 up to 65 (parents, and adults without dependent children) with incomes up to 138% of the Federal Poverty Level (FPL) based on modified adjusted gross income.  When you enter your income information into the Washington State Health Benefit Exchange Website, you will know right away if you are eligible for Expanded Medicaid.

More opportunities for subsidies
One of the ACA’s main goals is to make sure everyone can afford health insurance.  If you are between 138% and 400% of FPL, you are eligible for “tax credits.”  These tax credits can be applied towards your monthly premium to significantly lower your monthly premium costs.

How do I enroll?

October 1st, 2013 will mark the opening day of Washington State’s Health Insurance Marketplace also known as a Health Benefit Exchange.  The Exchange is an online marketplace that lets you compare and buy health insurance plans.  The name of our Exchange is “HealthPlanFinder.”

Open enrollment is from October 1st, 2013 to March 31st, 2014.  To apply and enroll, you must log on to and follow the instructions.  You will then be able to shop for health insurance plans by comparing them side by side, find out how much of a subsidy you can get, and if eligible, you will be enrolled in Expanded Medicaid.

Glossary of Terms:

Penalty Tax
If you don’t enroll in health insurance in 2014, you will pay additional taxes on your tax return.  These taxes will increase over time.

Open Enrollment
A period of time during the year when people can buy or make changes to a health insurance plan.

The amount of money you pay each month in order to have health insurance.

The amount of money the government payts to your insurer to help pay your premium.

The set amount of money you pay at the time of certain medical services.

The portion of your medical bill you pay, for certain services, after you meet your deductible.

How much you pay for certain services, in total, before your insurance starts to pay.  How much you pay depends on the plan you purchase.

Out-of-Pocket Maximum
The total amount you’ll spend for healthcare during the year, after which the insurance company pays for all your medical care until the year ends.

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