The online Marketplace will open in every state and open enrollment will last until March 31. Consumers will be able to check and see what insurance is being offered, what coverage options are available and whether they are eligible for a new tax credit to help make their premiums more affordable.
Private insurance companies offering plans through the Marketplace must cover most care, including: doctor’s visits, prescription drugs, lab tests, emergency care, hospitalization, rehabilitation services, preventive services, maternity and newborn care, pediatric care and mental health and substance abuse care.
The law requires all but the poorest Americans to have insurance as of Jan. 1, while providing financial assistance for many to make the coverage affordable. Those who already have coverage through their employer or through Medicare, Medicaid or other public programs are not required to purchase new coverage through the Marketplace. Insurance through the Marketplace will be available for people younger than 65 and legally living in the United States, as well as for business owners who employ fewer than 50 full-time people. Anyone incarcerated is not eligible.
There are several additional points consumers should know. For instance:
- More than 7 million people with heart disease or stroke are uninsured, making it sometimes difficult to get the right medical care at the right time, which then can lead to worse outcomes or higher rates of death. Under the law, people with pre-existing medical conditions will be protected and cannot be denied coverage or charged higher premiums.
- About 36 percent of people with heart disease or stroke are uninsured because they’ve lost a job or have recently started a new one. Financial help is available through the Marketplace for most people who are currently uninsured. The amount of financial assistance consumers will qualify for is based on income and family size.
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