Medicare Doesn’t Cover Everything; Supplemental Medicare Can Help Original Medicare doesn’t cover everything, and this can result in high costs and coverage gaps. Supplemental Medicare coverage like Part D, Medigap, or Medicare Advantage (Part C) can help. Understanding What Medicare Does and Doesn’t Cover and What You Can Do About It Medicare enrollees lack crucial…
On this page we ask the question, “did the ACA (ObamaCare) lead to higher medical costs, or is something else causing the increase in healthcare costs?”
Medicare and Hospital Costs: Medicare Networks, Medicare Assignment, Balance Billing, and Other Factors Related to Hospital Costs On this page, we discuss Medicare networks, Medicare assignment, balance billing, and the way hospital costs vary within a hospital (such as in the ER). Hospitals often charge more, sometimes a dozen times more, for services provided in the emergency…
We explain what happens to cost assistance (Tax Credits, CSR, and Medicaid) if ObamaCare is repealed by congressional Republicans under Trump.
An old lawsuit is rearing its ugly head again and it could lead to ObamaCare’s cost sharing assistance being defunded under Trump.
Updated Cost Assistance Information for 2017 For 2017, shoppers can get three types of health insurance cost assistance under the ACA: Premium Tax Credits, Cost Sharing Reduction Subsides, and Medicaid/CHIP. Below is updated cost assistance information for 2017 plans, including all plans purchased during 2017 open enrollment Nov 1. 2016 – Jan. 31. 2017. TIP: Seniors…
Find out about Health Care Sharing Ministries (HCSM), and related exemptions under ObamaCare. FACT: If your Health Care Sharing Ministry qualifies then you are exempt from the fee. Members of health care sharing ministries demonstrate their exemption by using IRS Form 8965 when filing their 1040 tax return. What are Health Care Sharing Ministries (HCSM)? Health Care Sharing…
Get the facts on low cost health insurance, how Medicaid and Marketplace subsidies can lower your costs, and how to get affordable coverage. Getting low cost health insurance is a little more complicated than just finding the right broker, picking the lowest premium plan, or general cost sharing amounts. It’s about understanding what cost assistance you…
Some say ObamaCare doesn’t do enough to control health care cost. Let’s look at how ObamaCare controls healthcare spending with cost controlling provisions. TIP: To find out what coverage under the Affordable Care Act will cost you, make sure to check out the healthcare.gov marketplace and find your cost after assistance is applied. Taxpayers are benefitting as…
Let’s take a look at factors that affect health insurance costs for premiums and cost sharing under ObamaCare, including Marketplace subsidies and Medicaid. ObamaCare helps ensure fair health insurance premiums (Sec. 2701), helps curb premium growth, and provides Tax Credits to lower premium costs. The ACA also includes measures to reduce out-of-pocket spending and curb national…
How to Calculate Tax Credits and Subsidies for Health Insurance Sold on the Health Insurance Marketplace Our ObamaCare calculator will help you calculate tax credits and subsidies for health insurance sold on the Health Insurance Marketplace. Use this quick health insurance tax credit guide to help you understand the process. Or, just use one of the…
What Does ObamaCare Cost? Below we look at what ObamaCare costs individuals and families, what ObamaCare costs taxpayers, and what ObamaCare costs in terms of government spending. FACT: The Affordable Care Act (ObamaCare) lowers costs based on income. Plans costs less than $100 a month for the majority of Americans who qualify for assistance each…
Assets are not counted for cost assistance subsidies on marketplace plans under the Affordable Care Act (ObamaCare). Only income is counted for premium tax credits and cost sharing reduction subsidies.
Under the ACA, health plans are ranked according to metals where the plans are ranked bronze, silver, gold, and platinum. Bronze has the lowest premiums and highest cost sharing, platinum has the lowest cost sharing and highest premiums.
In general, inheritance does not affect Premium Tax Credits or Cost Sharing Reduction assistance because inheritance is not taxable on the federal level and not considered income for federal tax purposes.
We explain how Trump can obstruct ObamaCare by “blocking insurer bailouts” (by not reimbursing insurers for cost sharing assistance.)
Preventive screening, including mammograms, is covered at not cost under ObamaCare but additional exams may have cost sharing or may not be covered.
Wellness visits and key preventive care are covered with no out-of-pocket costs, but some related services aren’t covered without cost sharing.
If you are charged for covered in-network services not subject to cost sharing. Don’t pay, call your insurer and healthcare provider and have them recode and resubmit the bill to the insurer.
You can switch plans mid-treatment but cost sharing doesn’t carry over from plan to plan so in most cases you should stick with the plan you are on until the end of the policy period.
Everyone gets one free preventive visit a year, other visits are subject to cost sharing, you may owe the full amount for a visit not coded correctly.
ObamaCare covers rehab for alcohol and drugs as part of it’s ten essential benefits. Treatment can still include cost sharing amounts and other limits.
If a doctor doesn’t accept ObamaCare (doesn’t accept Medicaid or a private plan you bought on the Marketplace), then they are considered out-of-network for purposes of cost sharing.
All necessary treatments are covered under all major medical insurances up to an allowed amount. Number of treatments may be limited and are subject to cost sharing.
You can switch between health plans, including ObamaCare, but you’ll lose your cost sharing. Also claims made during coverage gaps could be denied.