Affordable Care: Will It Ever Come to Be?

Affordable Care

The Patient Protection and Affordable Care Act will attempt to ease access to health coverage and attempt to strengthen regulations of private health insurance coverage. Much of the law’s key provisions take effect in January, 2014, at which time health insurers will be barred from charging more or denying coverage for individuals with a pre-existing condition such as cancer. Protection and Affordable Care Act provisions do not apply to all types of private coverage, but overall, the law will provide more protections to cancer patients and survivors in the private health insurance marketplace. The new health care law will give some cancer patients, survivors, and their families – as well as others who need to buy health insurance on their own –the opportunity to shop for a plan on a website called a health insurance marketplace (also called a health insurance exchange). People will be able to compare health plans by the amount of coverage they offer and price.

What is a Marketplace?

Enrollment starts October 1, 2013 and coverage begins January 1, 2014. Enrollment closes for the year March 31, 2014. You can enroll through www.Healthcare.gov/Marketplace, or find your state marketplace by calling this toll-free number 1-800-318-2596.

Who is Eligible?

If you are under 65 and don’t have access to health coverage through your employer or Medicare, you can buy a health plan through the insurance marketplace in your state. If you like your work health plan and want to keep it, you don’t need to buy insurance through the marketplace. If you or a family member loses a job or health insurance benefits, there will be new options that may be more affordable to you.

Will it Cover Everything I Need for Cancer Treatment/Follow-up?

The health care law allows more cancer patients and survivors to get the health care they need by requiring all health plans sold in new health insurance marketplaces to cover essential benefits. These include coverage for cancer screening, treatment, and follow-up care. The marketplaces will offer a variety of plans, and eligible people will be able to choose one that works best for them.

How Much Will it Cost?

Each marketplace will put the health plans into groups (platinum, gold, silver, or bronze) based on the cost of the plan. While bronze plans will have the lowest monthly premiums, they will only pay 60 percent of the cost of a medical service like a doctor’s visit or surgery, leaving you responsible for as much as 40 percent of the cost. Silver, gold and platinum plans will have higher monthly premiums, but you will pay less of the cost of care.

The marketplace will help people figure out if they qualify for help paying for health insurance or if their income makes them eligible for state programs such as Medicaid. Most people who make up to $45,960 per year and families of 4 with a combined income of up to $94,200 per year should be able to get financial help to buy a health plan through the marketplace. Depending on your income, you may also qualify for financial help to limit your out-of-pocket costs for medical services. Tax credits can be taken in advance to reduce monthly premiums or as a refund at tax time. For details on whether you qualify and for how much, visit www.healthcare.gov.

Although not a perfect plan, the Affordable Care Plan is a step in the right direction. I am hoping those representatives in Congress who have made the government shut down to avoid implementing this health insurance coverage will somehow see the light! They have the privilege of receiving incredible health care that we pay for and this should be an unalienable right for all citizens.