Until what age can kids stay on their parent’s health insurance?
The affordable care act allows young people to stay on their parent’s health insurance until they are 25 years of age. On the 26th birthday, the young people have to shop for their own policy cover.
What are two changes that make getting coverage easier than before for certain groups of people?
It is currently easier for people who have pre-existing conditions to access insurance at the same cost as those without such conditions. Previously they would have to pay higher costs because the risk factor for such people was considered to be higher. Under this reform, women will also not be required to pay more than men for healthcare policies (Public Law 111). Medicaid health policy which covered for people living at the poverty line in America was expanded. Under the ACA, even the lower middle class are now covered in Medicaid. This has enabled the members of the lower middle class access health cover because with the ACA it’s a mandate for individuals to have health covers, yet initially they were not included in Medicaid (Cathy et al 1762-1771).
If a private citizen does not get healthcare, how are they penalized? What is the website that brings together all the policy choices called?
A private citizen who does not get health cover will be penalized by having them pay a specified fee that increases progressively every year. There is a specified amount of fee that is to be paid per child, per adult and the maximum to be paid by a family. This is effective because of the individual mandate.
What is the 80/20 rule?
The 80/20 rule is also known as the medical loss ratio. This rule requires insurance companies to spend at least 80% of the money they get from premiums on actual health care costs and activities that will improve the quality of health care services. The other 20% can be spent on overhead, marketing and administrative costs. If an insurance company fails to meet the 80/20 requirements for a year, the policy holder will be paid back some money from the premiums paid-a rebate. This rule however is not applicable for companies with less than 1000 policy holders in a given market.
What is a lifetime cap and how does the ACA affect it?
A lifetime cap is a disease that one has to continuously receive treatment for, in most cases the disease is incurable and so the patient has to undergo treatment for life for example lifestyle diseases like diabetes. Insurance companies would pay for the patient’s continuous treatments up to a given limit after which they would stop paying. The ACA now requires insurance companies to continue paying for the patient’s treatment without limitation as long as they have the insurance policy.
How many employees does the business have to have before they need to worry about ACA penalties? What is a basic category of services that need to be covered by all policies under the ACA?
Under the ACA there is an employer mandate that requires employers who have 50 or more fulltime employees to provide them with health covers. The cover is inclusive of the employee’s dependents. An employer that does not provide this cover will be required to pay a given fee as a fine (Cathy et al 1762-1771). So a business should have 50 full-time employees before it begins to worry about ACA penalties.
The basic category of services that insurance policies must cover under ACA is the essential health benefits. It includes services such as preventive services, maternity and new born care, substance use disorders and mental health, prescription drugs, laboratory and ambulatory services.
What does capitation payment mean?
Capitation payment refers to an arrangement to pay healthcare service providers a certain amount of money for every patient assigned to them for a fixed period of time, whether the patient seeks care or not. The payment is usually made in advance to the practitioner. There are different capitation models that work for different organizations.
What is the main government website where you can refer people for more information?
The main government website that people can visit for more information on affordable cost care is www.healthcare.gov
Works cited.
Protection, Patient, and Affordable Care Act. "Patient protection and affordable care act." Public Law 111 (2010): 48.
Schoen, Cathy, et al. "Affordable Care Act reforms could reduce the number of underinsured US adults by 70 %." Health Affairs 30.9 (2011): 1762-1771.
