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laurenkem's avatar

Would you please help me understand how the new healthcare laws will work?

Asked by laurenkem (3388 points ) November 12th, 2012

I admit to knowing little about these changes. One of the things I do understand is that if an employer has 50 or more employees, then that employer has to provide health insurance for said employees. Does this mean that the employer actually has to pay for the insurance him/herself? Or does that employer simply have to pay to have the insurance plan in place and then employees sign up for the coverage, which they then pay for, either in part or in full?

I have to wonder how I will benefit from this plan? I’m 48 years old, I’m single, I have no children and I work as an independent contractor so that I am no one’s “employee”. I have also been without health insurance for the five years since my divorce and face a myriad of health problems. Does this mean that I will be left behind as far as health insurance? Just because I make money does not mean that I make the exorbitant amount required to pay for monthly healthcare on my own.

Any thoughts, please?

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20 Answers

Seek's avatar

This site gives a pretty good breakdown.

bkcunningham's avatar

@laurenkem, have you tried to get insurance on your own?

tedd's avatar

To my knowledge the companies that are required to carry insurance for having 50+ employees will be paying into those insurance policies (as to my knowledge every business that had an insurance plan does). The price is mostly paid by employee contributions, but the amount would vary by insurance company/plan/etc.

Given the profile of yourself you’ve listed: The new insurance law would mandate that no company could deny you insurance coverage or charge you a higher rate due to your pre-existing health issues. You will be legally required to obtain health insurance, but the government will be giving you what is essentially a voucher to offset, or outright pay for the insurance plan (companies will be mandated to have a plan that is affordable using only the voucher). If you fail to get a plan you will not be arrested or anything, but you will be charged a fee under the law. This fee is to offset the cost you will eventually incur upon the rest of us by going to a hospital without insurance (which the federal government pays for now and will continue doing in the future).

marinelife's avatar

1. As an independent contractor, it should be easier for you to buy your own health care coverage.

2. If you have pre-existing conditions they will be covered now if you buy heath insurance.

I have already seen the new health care laws in action. I had a soctor’s appointment for a physical last week. because it was a physical, under the new health care law, I did not have to pay a co-pay. the entire visit was covered.

bkcunningham's avatar

Are you saying that under the new healthcare law, regardless of your insurance carrier, the insurance company must provide you with an annual physical exam at no charge to you, @marinelife? I hadn’t heard that before.

Seek's avatar

Yes! And your gyno visit for birth control as well! Sweet, huh?

bkcunningham's avatar

Fabulous!

Judi's avatar

I just have to say that I’m smiling to se @bkcunningham say “fabulious” about the affordable care act.

laurenkem's avatar

So, I looked at the two links @Adirondackwannabe and @Seek_Kolinahr so kindly provided and they were both pretty helpful. @bkcunningham had a pretty good idea. I checked into Aetna, which has a plan for about $120/month. Not bad, right? Yeah, once you get past the $10,000 deductible. So nix to that. I moved on to Cigna, which, while $300/month, only charges a $2,500 deductible, and that seemed fairly reasonable. Frankly, however, my biggest worry is hospitalization coverage – I can afford to go to the doctor for your everyday ailments. I generally end up being hospitalized every few years. And Cigna’s plan states, with regard to hospitalization, that it covers ”$500 Additional Deductible per admission then 20% Coinsurance after plan deductible” Is that insurance speak for telling me that they’re only going to pay 20% of my hospital bill?

God, I’m so ignorant about this stuff

tedd's avatar

@laurenkem Well looking right now you have to keep in mind the majority of the healthcare bill isn’t in effect. It won’t be until 2014. Right now there are just some of the more basic things like children not having pre-existing condition clauses and what not. If you have an emergency illness and need to get insurance, there are pools/plans for that available now. But I’m not certain how serious an issue you’d need to be added to one, and you still have to pay them like a regular plan.

bkcunningham's avatar

@laurenkem, I’m assuming you haven’t actually applied for a private insurance plan. Is that correct?

Adirondackwannabe's avatar

@laurenkem 20% coinsurance usually means the insurance company pays 80% and you pay 20%

laurenkem's avatar

@bkcunningham No, I never had to apply for a private insurance plan. I was always just covered under my ex-husband’s plan, which is why I really know nothing about it.

@Adirondackwannabe , thanks for that info. If they pay 80%, that seems pretty good to me!

augustlan's avatar

Something that’s in force now is that if you have a pre-existing condition, you can get health insurance right now, through your state’s PCIP (or the federal government if your state doesn’t have a plan). You pay for it, so it’s not a handout, but prior to this you might not have been able to get insurance at any price (I was denied by every insurance company out there.) Check out https://www.pcip.gov/ for more info. This has been a godsend for me.

bkcunningham's avatar

The Florida plan is horrible, @augustlan. I can’t wait until Obamacare kicks in so people here won’t have to contend with the Florida PCIP where they are paying a minimum $270 a month for nothing. It will be great when they get the best healthcare there is for free!

laurenkem's avatar

Well, that’s terrible news for me then, @bkcunningham ! I live in Florida – I hate all this crap.

@Seek_Kolinahr, I can live without the free birth control since I’m pretty safely out of my child-bearing years and haven’t even had a boyfriend in 2 years! I’m not saying I’m happy about it, I’m just mentioning it.

The choice of men in Florida sucks

Seek's avatar

Ugh. There’s nothing good about this state. We all need to GTFO.

laurenkem's avatar

@Seek_Kolinahr – well….......I must say I do appreciate it being close to 80 degrees on November 13th. I hate cold!

bkcunningham's avatar

I’ve lived all over the eastern US and there isn’t any place I haven’t enjoyed. I must say, I love living in Florida too, @laurenkem.

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