What You Need to Know about the Affordable Care Act: The Basics

Various provisions of the Affordable Care Act (ACA) will have implications for the Parkinson’s community. So what does it all mean to you?

Getting Started:

  • Video: Get the basics from the Kaiser Family Foundation. 

  • Timeline: Understand which provisions will be put in place and when they affect you. Source: Kaiser Family Foundation.
  • HealthCare.gov: This website and 24-hour consumer call center will help you navigate the Health Insurance Marketplace, also known as exchanges, and understand the broader health care reform education and outreach plan.
  • FAQs: PAN has put together a frequently asked questions page to answer more of your questions.
  • PAN Policy: Learn more about what the Parkinson’s Action Network is doing to ensure Parkinson’s patients’ needs are met by ACA.

What You Need to Know - A Deeper Dive:

Health Insurance Marketplace (Exchanges)

  • Beginning January 1, 2014, state-based Health Insurance Exchanges and Small Business Health Option Program (SHOP) exchanges will begin operations nationwide. 
  • Open enrollment for the exchanges will begin October 1, 2013 and run through March 31, 2014.
  • States that opt not to develop an exchange program will have one administered directly by the federal government. 
  • The exchanges will allow individuals and small businesses with up to 100 employees to purchase qualified health insurance coverage. 

 

For those purchasing through the Exchanges, there may be subsidies available to help reduce the costs of your premiums. Use this subsidy calculator provided by the Kaiser Family Foundation to see if you may qualify for assistance.

Essential Health Benefits

  • Beginning in 2014, the ACA requires health plans for individuals who are uninsured or who will be insured through an individual or small group policy to offer a comprehensive package of Essential Health Benefits (EHB). 
  • EHB must include items and services within at least 10 categories:
    • Ambulatory patient services
    • Emergency services
    • Hospitalization
    • Maternity and newborn care
    • Mental health and substance use disorder services, including behavioral health treatment
    • Prescription drugs
    • Rehabilitative and habilitative services and devices
    • Laboratory services
    • Preventive and wellness services and chronic disease management
    • Pediatric services, including oral and vision care.
  • Learn more about PAN’s policy work on essential health benefits.

Additional Online Resources