Claire McAndrew
Blog Post List
January 6, 2011
Question: Last year, for the first time, I was able to afford health insurance. When I ended up in the hospital, I thought that my health plan would cover all of the care I needed. But, it turned out that I still had huge bills from my stay because my plan has an “annual limit.” Will health reform do anything to stop plans from putting low annual caps on coverage? Answer: Unfortunately, many consumers have been in this situation: They purchase a health plan that sounds like it offers high-quality coverage, only to learn that the plan doesn’t pay many of their medical bills because it has an “...
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November 4, 2010
Health Reform Question of the Week: I have heard that beginning in January 2011, I will have to pay taxes on my family’s health insurance, which I now obtain tax-free through my employer. My family and I are proud to pay our fair share of taxes, but our budget is already tight and we have little money to spare. Will we face new taxes on our health insurance in January? No. The Patient Protection and Affordable Care Act does not require everyone to pay new taxes on their health insurance. And there will not be any new taxes on health insurance benefits starting in January 2011. What may start...
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October 21, 2010
Health Reform Question of the Week: How will the penalties for not having coverage be enforced? I already can't pay for coverage now—will I be fined or sent to jail if I don’t have health insurance? ANSWER: The Patient Protection and Affordable Care Act (or “Affordable Care Act”) is designed to make sure that people who can afford health insurance obtain it and that those who can’t afford it receive help to make it affordable for them. So, if you earn less than 400 percent of the federal poverty level (or $43,320 in 2010), you may be eligible for a subsidy to help you pay for coverage. The...
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October 11, 2010
Question of the Week: I have a “pre-existing condition” because I had a joint in my leg fixed from a sports injury. Since the repair has been made and no additional work is required, I think it is unfair that this is considered a pre-existing condition that makes me ineligible for insurance that I can afford. Is there anything in heath reform to address this? Yes. The Patient Protection and Affordable Care Act includes landmark reforms that will vastly improve access to health coverage for people with so-called “pre-existing conditions.” By 2014, insurers will no longer be allowed to refuse...
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September 30, 2010
Question: Will there eventually be a public option? Answer: The Patient Protection and Affordable Care Act, signed by President Obama on March 23, 2010, is a huge step forward for health care consumers. It will bring quality, affordable coverage to all Americans through the creation of health insurance exchanges (marketplaces where people can shop for coverage with user-friendly information about quality and costs, like what members of Congress and Federal employees use); income-based tax credits to help people afford coverage; and the expansion of Medicaid, the federal-state partnership...
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September 13, 2010
I have a 22-year-old daughter without health insurance. She is a part-time college student and works for an employer who does not offer health insurance. I work full time at a hospital and have coverage through my employer, and my employer also offers dependent coverage. I've heard that with the new health care law, my daughter will be able to enroll in my employer-based insurance and stay on the plan until she turns 26. Is that true and when would this take effect? Yes, it’s true that your daughter will be able to receive coverage under your insurance plan until her 26th birthday because of...
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August 10, 2010
QUESTION: I am an active person. I exercise and eat right, maintaining a healthy life style. I have been doing so for more the 3 years now. Will my premiums be lower because I am staying healthy? There are two main insurance company practices to discuss when it comes to this question: health status rating and wellness incentive programs . Health Status Rating Currently, health insurers in most states set premiums for people looking to purchase coverage on their own (in the individual market) based on their health status. This means that insurers can look at medical histories and any health...
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August 2, 2010
Q: I work in a small business. We just learned that our premium is going up 33% so we will need to go with a different, less expensive plan with less generous benefits. Will the Department of Health and Human Services ever be looking to scrutinize these types of rate hikes to see if these rate hikes are justified? A: Under reform, insurers will have to submit transparent information to regulators on how they calculate their premium rates, justifying any rates that seem unreasonable. Health reform also provides new funding for states to implement or enhance oversight of health insurers’...
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July 27, 2010
I have been unemployed since December 2008, and my husband works for a very small company with 5-6 employees that does not offer healthcare. Will health reform mandate all employers, regardless of size, to provide healthcare? Health reform does not mandate that small employers offer coverage to their workers. However, it does make it easier for small employers to offer coverage. Health reform provides employers with up to 25 workers with tax credits to make coverage more affordable—increasing the likelihood that they will offer coverage. Starting this year, small employers can get tax credits...
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July 20, 2010
Will health reform require new health care plans to cover pregnancy care and delivery by midwives? Will lactation consultants’ services be covered? Under health reform, health plans will cover standardized, comprehensive benefit packages. The law sets out general categories of benefits that must be covered, and these categories include maternity and newborn care. The details of the specific services that will be covered under each category will be determined by future regulations from the Secretary of Health and Human Services. The law specifically requires the Secretary to consider the...
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