FDA Approves New Alzheimer’s Treatment The U.S. Food and Drug Administration (FDA) recently approved Biogen and Eisai Co. Ltd.’s Alzheimer’s treatment, Leqembi, also known as lecanemab. This ground-breaking drug is designed to reduce the buildup of amyloid beta plaque in the brain – a hallmark of Alzheimer’s disease. This is a significant step forward, as… Read More
Medicaid eligibility depends on income and family size, not hours worked. Further, you can apply regardless of your income, you’ll just be rejected or pointed at the marketplace if you make too much to qualify.
If you are clocking out for lunch and not working during lunch, then those hours can be deducted from your total hours for the purposes of determining Full-Time status.
Despite attempts at repeal and a lawsuit that may jeopardize the future of the ACA, ObamaCare is still active and most provisions are in place.
ObamaCare covers coronavirus. All marketplace plans cover FDA-approved coronavirus tests and vaccines with no out-of-pocket costs. The same is true for Medicaid/CHIP as well.
Anyone living in the United States who is a citizen or legal resident, and who is not incarcerated, is eligible for ObamaCare’s cost assistance based on income if they make between 100% – 400% of the Federal Poverty Level.
What Types of Preventive Care Does ObamaCare Cover? Under the Affordable Care Act (ObamaCare) all adults get 15 services covered for preventive care, women specifically get 22, and kids get 26. Below is a list of covered services. FACT: ObamaCare includes preventive care at no out-of-pocket cost on most health plans. ObamaCare’s free preventive services… Read More
Everyone who has health coverage uses ObamaCare in one way or another. It is a misconception that only one demographic is impacted by the Affordable Care Act. Those who are impacted the most by ObamaCare’s provisions are those covered under the expansion of Medicaid, those who qualify for cost assistance, those who got covered by… Read More
Health Insurance Denial and Cancellation Appeal Rights Under the Affordable Care Act (ObamaCare) Customers have appeal rights for the denial of health insurance claims, the cancellation of health plans, and marketplace decisions under the Affordable Care Act (ObamaCare). However, one must appeal within the proper timeframe. TIP: For more details on appeals, see our page… Read More
An employer can cut back hours, but once you qualify for employer health insurance they must offer coverage until the end of the calendar year.
Deferred Action for Childhood Arrivals (DACA) recipients are not eligible for ObamaCare, don’t have to comply with the mandates, can’t use the marketplace, and can’t get cost assistance.
Those who want to repeal ObamaCare due to being upset with the cost or the mandate should think carefully about why guaranteed coverage for preexisting conditions matters.
A final rule from HHS prohibits discrimination based on race, color, national origin, sex (and gender identity), age, or disability.
If your health insurer refuses to pay a claim or ends your coverage, you have the right to appeal the decision and have it reviewed by a third party.
Gender based pricing rules apply to new plans in the individual and small employer markets. They do not apply to grandfathered plans, large employers, or self insured businesses.
Preventive screening, including mammograms, is covered at not cost under ObamaCare but additional exams may have cost sharing or may not be covered.
A legal immigrant can buy a private plan or get cost assistance through ObamaCare (if they file taxes), but can’t get Medicaid before 5 years in most cases.
The ACA does not require coverage of prophylactic mastectomy or reconstruction procedures, but some state laws do. Thus it will be plan specific and state specific.
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 an employer offers grandfathered or large group coverage that doesn’t offer all benefits of the ACA it may still count as minimum essential coverage.
A public company can refuse to offer birth control for religious reasons, but a third party must provide free birth control to all employees with coverage.
The Affordable Care Act covers screening and counseling for domestic and interpersonal violence as a free preventive service for women.
College students have a number of health plan options including the Marketplace, Medicaid, school health plans, catastrophic plans, and their parents plan. Below we take a look at student health options under the Affordable Care Act (ObamaCare). FACT: A university health plan counts as Minimum Essential Coverage for ObamaCare if it’s fully insured or self insured. Aside… Read More
Out-of-network emergency care is covered under all insurance plans sold after March 23rd, 2010 as part of Ten Essential Benefits under the Affordable Care Act.
Employees can get free contraceptive coverage on employer plans, even if an employer is exempt from offering contraception for religious reasons. Coverage is provided through a third party and is not provided by the employer.