Benefits, Rights, & Protections

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

Your health plan’s Summary of Benefits and Coverage (SBC) is a summary of what your plan covers in terms of benefits and cost sharing, and explanations of how everything works. We suggest opening up a Summary of Benefits and Coverage sheet as you follow along. The Summary of Benefits and Coverage PDF can be found… Read More

Insurance Companies Can’t Cancel Coverage For Any Reason Other Than Fraud or Non-Payment ObamaCare bans rescission (rescinding health coverage), in other words, insurers can’t cancel coverage from any reason aside from non-payment or fraud. Before the ACA an insurance company could find a small detail like a mistake on your application, or the omission of… Read More

Protecting You Against Unfair Premium Increases ObamaCare’s rate review provision and the 80/20 rule help keep curb premium growth and keep insurance affordable. Before the ACA premiums had been increasing at unsustainable rates on a yearly basis, the ACA’s new provisions help to curb that. There are two ways insurers are now held more accountable… Read More

You Can’t Be Charged More Due to Gender or Health Status ObamaCare means no discrimination. Under the ACA you can’t be charged more due to gender or health status on individual or small group plans sold after 2014. However, there are certain factors such as age, tobacco use, family size, and geography which can be… Read More

ObamaCare and Appeals – Everything You Need to Know About Expanded Appeal Rights Under the Affordable Care Act The Affordable Care Act (ObamaCare) expanded health insurance appeal rights. Under the ACA it easy to appeal any health insurer or marketplace decision. Specifically, you have the right to an internal and external appeal of any decision… Read More

You Can’t Be Denied Coverage For Any Reason ObamaCare makes health insurance guaranteed issue meaning you can’t be denied health status, age, gender, or other factors. Just because insurance is guaranteed issue doesn’t mean you can’t be charged more for certain factors, although the ACA limits this as well. Below we will list the factors… Read More

The Affordable Care Act and Annual and Lifetime Dollar Limits The Affordable Care Act (ObamaCare) stops insurers from setting yearly or lifetime dollar limits on essential benefits. Since 2014 health insurance companies have had to follow new rules on what benefits can be subject to dollar limits and what dollar limits can be set. Let’s… Read More