Do All ObamaCare Plans Have to Cover Lung Cancer Screening?


Yes. Since cancer screenings are a preventive service (one of ObamaCare’s Minimum Essential Benefits), all ObamaCare health insurance plans have to cover lung cancer screenings. In most cases, this service must be offered at no out-of-pocket costs.

ObamaCare Cadillac Tax (Excise Tax on High End Plans)


ObamaCare’s Cadillac Tax is a 40% excise tax on high end plans above $10,200 for individuals and $27,500 for family coverage that was set to start in 2018 but was been delayed. This tax is not deductible. The excise tax is one of the main revenue sources for the ACA, helps curb healthcare costs, and… Read More

Out-Of-Network for a Pre-existing Condition, What do I Do?


If someone needs treatment out-of-network for a pre-existing condition they either need to pay out-of-pocket, pay their out-of-network cost sharing amount, get approval from the insurer, or switch to a multi-state plan.

Self-Employed Health Insurance


ObamaCare and Health Insurance for the Self-Employed The Affordable Care Act (ObamaCare) has some important implications for how the self-employed go about obtaining, maintaining, and paying for health coverage. If you’re self-employed, most of the healthcare provisions in the ACA apply to you.  Let’s take a look at how you’re affected by ObamaCare, how you can reduce the cost of coverage, and how… Read More

Can I Be Denied Care without Coverage?


In America we don’t turn people away in emergencies, but you won’t be able to get care outside of an emergency unless you pay out-of-pocket or have a health plan.

Do I Lose Cost Sharing Amounts I Paid if I Switch Plans?


Out-of-pocket cost sharing amounts are based on policy periods and holding a specific policy. So don’t switch health plans mid-year if you have already paid a considerable amount in.

What if I Had a Coverage Gap During Open Enrollment?


You will want to take exemption CODE “G” for not having coverage during open enrollment. CODE “B” is for a short coverage gap of less than 3 months. CODE “G” covers you as long as you applied during open enrollment and then enrolled in a Marketplace plan.

Health Care Sharing Ministry Exemptions


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… Read More

Vision Insurance


Affordable Care Act Vision Coverage Vision insurance generally isn’t covered under the Affordable Care Act (ObamaCare).  However, pediatric eye care is a required benefit included on all plans that qualify as minimum essential coverage under the ACA. Even though adult vision coverage isn’t a required benefit of ObamaCare, “vision health” is still an important aspect… Read More

ObamaCare Replacement Plan: “CARE” Act Facts


Get the facts on the ObamaCare replacement plan by Burr, Hatch, and Upton: the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act. Below we present a summary, some quick facts, a pros and cons chart, a complete section-by-section breakdown, and finally we compare the CARE Act proposal to ObamaCare. Keep in mind this is an older replacement… Read More

ObamaCare: 10 Million Strong and Growing

ObamaCare sign up numbers reach 10 million after a surge in Federal Marketplace enrollments. A February 2015 HHS report shows ObamaCare is working. Enrollment numbers have surpassed 10 million between the state and federal marketplaces. It also points out some other really cool and groundbreaking facts about the uninsured rate (updated with citations on March 18 2015)…. Read More

Vaccine Facts: Facts & Myths on Vaccination


Get the facts on vaccines. Should we vaccinate our children, should I get the flu shot, what are the risks, pros, cons, and myths? We uncover the truth. FACT: The flu vaccination and other vaccinations are covered at no out-of-pocket cost on all major medical plans under the Affordable Care Act (ObamaCare). That means if you… Read More

Low Cost Health Insurance


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… Read More

ObamaCare and Immigrants


Let’s look at how ObamaCare affects immigrants and how immigration status affects Marketplace coverage, cost assistance, Medicaid, and coverage requirements. Most immigration statuses qualify people to use the Marketplace, but only lawfully present immigrants have access to cost assistance and are required to obtain coverage. Limitations apply to specific groups in regards to Marketplace coverage, Medicaid, and… Read More

What are Health Insurance Networks?


How Health Insurance Networks Work With Health Insurance The general types of networks are HMOs and PPOs. A given provider will then either be “in-network” or “out-of-network” for a given plan. You and your insurer save money by using “in-network providers.” You’ll almost always have different cost-sharing when you use a provider “out-of-network,” so you’ll… Read More

How Does ObamaCare Control Costs?


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… Read More

Marketplace #GetCovered Story

Alicia, 39, and Rusk, 37, have been married for 14 years, and have two sons, 11 and 7. Alicia, a former teacher, and Rusk, who owns an auto repair shop, did not have health insurance until the Health Insurance Marketplace opened last year. The 2015 premium for Rusk and Alicia is $373 a month, much… Read More

What is Cost-Sharing?


Cost-sharing in health insurance is your share of costs (copays, coinsurance, deductible, out-of-pocket maximum) for covered benefits in a policy period. Typically cost-sharing does not apply to Premiums, uncovered costs, or balance billing. TIP: In simple terms, cost-sharing describes your share of the costs vs. your insurer’s share of the cost in respect to your… Read More

Platinum Plan


ObamaCare’s Platinum Plan is a type of Metal Plan on the Health Insurance Marketplace. Platinum Plans qualify for Tax Credits and have the highest premiums. Other Metal Plans include Bronze, Silver, and Gold. Also, a Catastrophic Plan is available to young adults and to some people with hardship exemptions. Platinum plans have the highest premiums and the lowest cost-sharing. They only make… Read More

Gold Plan


ObamaCare’s Gold Plan is a type of Metal Plan on the Health Insurance Marketplace. Gold Plans qualify for Tax Credits, have high premiums, and generous cost-sharing. Other Metal Plans include Bronze, Silver, and Platinum. Also, a Catastrophic Plan is available to young adults and to some people with hardship exemptions. Gold plans mean higher premiums, less Tax Credits, but much… Read More

Bronze Plan


ObamaCare’s Bronze Plan is a type of Metal Plan on the Health Insurance Marketplace. Bronze Plans qualify for Tax Credits and have low premiums. Other Metal Plans include Silver, Gold, and Platinum. Also a Catastrophic Plan is available to young adults and to some people with hardship exemptions. All plans offer basic benefits and minimum cost-sharing, Bronze Plans tend… Read More

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