As the U.S. prepares for open enrollment in the Health Insurance Marketplace, consumer health advocates worry about costs and access to care. In this recent New York Times article, consumer health advocates fear that the new Marketplace would limit the number of eligible providers and specialists accessible to participants. House Republicans have voiced concerns and threatened to defund Obamacare.
Even so, the point of the Patient Protection and Affordable Care Act (PPACA or ACA) is to make coverage both affordable and available. According to the ACA official text, information would be made readily available to consumers through an "Internet portal" helping them compare affordable coverage options. Individuals will be able to enroll in the Health Insurance Marketplace as of October 1 (more information can be found via https://healthcare.gov). Open enrollment for small businesses is delayed until November 1. Read more in our blog about the delay in online enrollment for many small businesses.
A Census Bureau report revealed that the number of Americans not covered by health insurance decreased in 2012, but there are still 48 million Americans who remain uninsured.
When is coverage affordable?
In order for coverage to be deemed affordable (as outlined on healthcare.gov), "as it relates to the Advanced Premium Tax Credit (APTC), the employee's share of the annual premium for self-only coverage [must not be] greater than 9.5% of annual household income."
Additionally, a health plan must meet a minimum value - it "meets this standard if it's designed to pay at least 60% of the total cost of medical services for a standard population."
Does my Flexible Spending Account help?
A Flexible Spending Account opens doors to eligible services not covered by your regular insurance plan. An FSA lets you pay for out-of-pocket expenses (deductibles, coinsurance and copays) when you visit health care providers such as dentists, chiropractors, acupuncturists, ophthalmologists and more. Find local FSA eligible services via FSAstore.com!
Starting in 2014, the Health Insurance Marketplace plans must also cover what are known as essential benefits. Theseessential benefitsinclude "ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care."
The benefits of an FSA extend beyond coverage for eligible medical services as these accounts are pre-tax. You're saving up to 30% on medical expenses with an FSA.
Stay updated on all health reform and FSA news right here on the blog. Or, find FSA eligible products on FSAstore.com!