Talking Turkey: New Health Coverage Your Family Needs To Know About

Sunday, 3 Nov 2013, 8:05:00 AM

Ron Pollack

Ron Pollack, Families USA Executive Director
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Ron Pollack, Families USA Executive Director

Thanksgiving is special – it may be the most family-focused holiday in our calendar. This year, many parents and grandparents can play a unique role, particularly if their children or grandchildren don’t have health insurance because they can’t afford it. Perhaps these families were denied coverage or were forced to pay higher premiums because of a pre-existing condition. But that’s all changing.

How can you be sure that your family knows about the new health coverage options? Now that the state health insurance marketplaces are open, we’ve entered a new, improved world of health insurance shopping. Not only are insurers racing to get into state marketplaces to offer policies at competitive prices, but they’re also offering products that are easier to compare.

Comparison shopping for health care policies is easier now because of a measure in the health care law called the “Summary of Benefits and Coverage.” This is a simple four-page document that all insurers must provide to their own policyholders and to consumers shopping for coverage.

The summary provides a concise, plain-language description of the benefits and costs of a

particular health plan. It allows apples-to-apples comparisons of what the policies offer – no more searching the fine print for what a policy really

With the ability to compare identical features across plans, people can now shop for insurance the way they shop for a car.

And, like choosing between low-end or luxury vehicles, the marketplaces offer a wide variety of plans from a variety of insurers. Shoppers can look at bare-bones “bronze” plans, which have the lowest premiums, or they can go right to the top and choose from “platinum” plans that are offered. It’s all private insurance – not a government plan, as some claim – and there are plans designed for every budget and family need.

And what about those hurdles that prevented people from buying coverage in the first place, like high premiums or denials for pre-existing conditions? You and your family don’t have to worry about those now, because the Affordable Care Act removes these obstacles. Because of the health care law, insurers can no longer deny coverage or charge higher premiums for a family member who has or once had a health issue.

Premium tax credits are now available for middle- and moderate-income people who do not have job-based health insurance. This financial assistance extends to families of three with annual incomes up to $78,120, and to individuals with annual incomes up to $45,960. The size of these tax credits will vary: People with lower incomes will get bigger tax credits, while those with somewhat higher incomes will get smaller tax credits.

Buying health insurance is still a big decision for a family. But the Affordable Care Act makes this decision easier. Now, you can compare policies readily, receive financial assistance if you qualify, and rest assured that insurers won’t deny you or your family member coverage due to a pre-existing condition.

There may still be confusion about health reform, but you can help your family learn about the options that could truly make a difference in their lives.

Thanksgiving is coming, and families will be together. To prepare for that big gathering, check out the new state insurance marketplaces yourself. Guide your family to choose wisely and get covered.

You’ve raised a family, and you understand how important it is to be able to get quality health care. Now you can help your family find the peace of mind that comes from knowing they can get the health care they need when they need it. As you spend time with your family this holiday, you’ll all have much more to be thankful for.

Families USA is the national organization for health care consumers. It has advocated for universal, affordable, quality health care since 1982.

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