As regular readers of SS&Y are aware, the Social Security Administration administers 2 trust funds. The Old Age Survivors Insurance (OAS’) fund pays retirement benefits. The Disability Insurance fund (DI) pays disability benefits. When Congress passed and President Obama signed the Bipartisan Budget Act in November of 2015 to reallocate current contributions between the OASI…
The Social Security Administration has announced there will be no Cost of Living Adjustment in 2016 for the nearly 65 million Americans drawing Social Security disability, retirement or SSI benefits. This is because there was no inflation between the third quarter of 2014 and 2015 as measured by the Consumer Price Index for Urban Wage…
Spring-Summer 2015 Newsletter SSDI Insolvency Looms We’ve known it’s been coming for some time and now it’s on our doorstep. Unless Congress acts the Social Security Disability Insurance Trust Fund (DI Trust Fund) will become insolvent late next year and unable to pay full benefits any longer. Millions of Americans who rely on their disability checks for most, if not all,…
Fall 2014 Newsletter OBAMACARE UPDATE On October 1st it will have been a year since enrollment began in the Affordable Care Act national health insurance program known as Obamacare. The difficulties in the early weeks and months have been well documented. But where are we a year later… Read the Newsletter in PDF format. Read the Newsletter in PDF…
The Patient Protection and Affordable Care Act, better known as Obamacare, takes effect January 1, 2014. Open enrollment begins October 1, 2013. Plans and prices will be available then. Open enrollment closes March 31, 2014.
A visit to www.healthcare.gov/ will give you information regarding the Healthcare Marketplaces available in your state. Providers fall into 1 of 5 categories. There are Health Maintenance Organizations (HMO), Exclusive Provider Organizations (EPO), Preferred Provider Organizations (PPO), Point of Service plans (POS), and High Deductible Health Plans (HDHP).
If you employer provides health insurance your options will be limited by the plan your employer chooses to provide. If your employer does not provide health insurance, the Marketplace is the place to go. Some states will run their own healthcare exchanges. Some will use a federal exchange. And some states will have a partnership between the state and the federal government. Michigan falls into the last group. Plans will vary by state but 4 levels of coverage will be offered: bronze, silver, gold and platinum.
By visiting the above site you can get information regarding these various options and sign up to receive information about the providers in each category in your state.
A health center locator can be found at findahealthcenter.hrsa.gov/SearchHCC.aspx. Simply type in your location (zip code works well) and free and low costs healthcare sites will be displayed.
Most plans must provide certain preventive services, such as shots and screening tests, at no cost to you and most health plans cannot charge you more or refuse to cover you because of a pre-existing health condition. And beginning in 2014 you may not be turned down or be charged a higher premium because you are pregnant.
Information regarding the Children’s Health Insurance Program (CHIP) can also be accessed. Each state has a CHIP program but the benefits provided vary from state to state.
If you meet your state’s criteria for Medicaid you will be eligible for a free or low-cost health plan and will not need to buy a Marketplace plan. Beginning October 1, 2013 when you fill out an application for the Marketplace on line you will be informed if it looks like you qualify for Medicaid.
Similarly, if you have Medicare you need not buy a plan through the Marketplace, whether you have original Medicare or a Medicare Advantage Plan.
If you have job-based insurance coverage which qualifies as minimum essential coverage under the law you need do nothing. But if your employer currently covers all or a portion of your health insurance you may find yourself thrust into the Marketplace, if your employer chooses to discontinue that contribution.
There are other protections built into the Affordable Care Act. For example, frivolous cancellations are barred. For example, if you make a minor error on your application currently the insurance company can cancel your coverage. This will no longer be permitted. You may use an out of network emergency room without penalty. Persons under 26 years of age may stay on their parent’s coverage. A right to appeal coverage decisions is guaranteed. And there will no longer be yearly or lifetime limits to coverage.
It is also important to realize that if you do not have insurance and do nothing you may have to pay a fee.
So it is important to fill out the Marketplace application on line, shortly after October 1st to learn your options and get ready for the future of healthcare.