Make your health a priority: Enroll in Marketplace health insurance by the January 31 deadline – National Consumers League

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There is considerable anxiety over the future of healthcare in the face of our new Administration. However, the most important thing that consumers can do right now to protect their health is to enroll in or change their Marketplace health insurance plan by the January 31, 2017 deadline.

Consumers can go to HealthCare.gov to find a plan that best fits their needs and budget.

Why is having health insurance important?

  • It protects you and your family from unexpected medical costs. No one plans to get sick or hurt, but health insurance gives you important financial protection, just in case.
  • Marketplace health insurance gives you access to essential health benefits (like emergency services, maternity and newborn care, and prescription drugs) and preventive health services (like vaccines and screening tests) at no cost to you.
  • Marketplace plans may be more affordable than you think. About 85 percent of Marketplace consumers qualify for tax credits to assist with costs. At HealthCare.gov, you can find out if you qualify for financial help with your premium costs.

Contact HealthCare.gov’s Marketplace Call Center toll-free at 1-800-318-2596 for assistance with enrolling. If you have more questions about health insurance, we encourage you to visit MyHealthPlan.Guide, a joint project of NCL and America’s Health Insurance Plans, which provides helpful tips about choosing and using your health insurance plan.

Don’t miss out on your chance to get covered–enroll by the January 31 deadline. Make your health a priority–you owe it to yourself!

Preventive care benefits: Your health plan’s best kept secret – National Consumers League

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To those who may question the necessity of health insurance, I have two words for you: Preventive care. Seven out of ten deaths among Americans each year are from chronic diseases, many of which are preventable. Preventive health services like physicals, immunizations and other screenings can help find health problems early, when the chances for treatment and cure are better, or even prevent health problems before they start. 

Preventive health services are covered under all health insurance plans with no additional out-of-pocket costs when provided by in-network providers. Your health insurance plan may cover even more services that cost you nothing – to find out more, be sure to contact your health plan.

Unfortunately, many consumers with health insurance don’t take advantage of these services – simply because they don’t know their insurance covers it.  That’s a problem we’re working hard to resolve.

Below we list some of the preventive care benefits available through your health plan: 

For adults:

Immunizations (Vaccines)

It is important for adults to stay up to date on their immunizations.  They can save your life and save your health.  Through your health plan, vaccines for diseases such as chicken pox, tetanus, diphtheria, and pertussis, hepatitis A & B, and the flu are all covered. 

Depression screenings

Too many people suffer from mental health conditions, such as depression, and the consequences can be devastating on individuals and families alike. Taking a depression screening is one of the most efficient and effective ways to determine whether you are experiencing symptoms of depression and get you on the path to treatment. Depression screenings are fully covered by your health plan. 

Cancer screenings

Nearly everyone has felt the impact of cancer – either themselves or a friend or loved one.  Screenings are one of the most powerful weapons against cancer. When many cancers are found early, chances of survival increase exponentially. Important preventive cancer screenings include cervical cancer screening, breast cancer mammography screening, and colorectal cancer screening. Lung cancer screening is also covered for adults aged 55-80 who are current smokers or have quit smoking in the last 15 years. 

For women:

Well-woman visits

Well-woman visits are key to women’s health and help identify health concerns before they become life-threatening. These visits usually include your annual physical examination, as well as any necessary screenings (such as pap tests, blood pressure and cholesterol screenings), evaluations, counseling, and immunizations based on your age and risk factors. 

Services for pregnant women or women who may become pregnant

In addition to the preventive services available to all women, there is also a list of services available for mothers-to-be. Breastfeeding support and counseling, gestational diabetes screenings, anemia screenings, and even folic acid supplements for women who may become pregnant are all covered under your health plan – at no additional cost to you. 

For children:

Autism screenings

The American Academy of Pediatrics recommends that children are screened for autism at their 18- and 24-month well-child visits. This type of screening can quickly identify children with developmental and behavioral challenges when early treatment may be most effective. 

Vision screenings

Good vision is essential to a child’s development, success, and overall well-being. Their vision should be checked when they are first born, while they are a baby, and through their preschool and school years. If problems with a child’s vision are not detected early, their vision may become limited in ways that cannot be rectified later in life. And it can also affect school performance and learning.  But with early detection, it is usually possible to treat vision problems effectively. Thankfully, vision screenings for all children are covered through your health plan. 

Be on the lookout for new resources from the National Consumers League (NCL) and America’s Health Insurance Plans (AHIP) to help consumers get the most out of their health insurance benefits.

What you need to know about your health insurance benefits – National Consumers League

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stethoscope_heart_92.jpgIt’s no secret that choosing a health insurance plan isn’t as easy as ordering at a restaurant. Even after purchasing a plan, actually understanding what exactly you’ve purchased is yet another stressful task. Health insurance can confuse even the savviest consumers. Read on for a few tips every consumer should know when it comes to health insurance benefits.


Your health plan most likely offers essential health benefits.

All plans purchased through the Affordable Care Act (ACA) marketplace and the majority of health plans provided by employers are required to provide a core group of medical services called essential health benefits. These services include:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, 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

To find the full list of services your plan covers and how much those services cost, check your Summary of Benefits and Coverage (SBC). You can request a copy of this document through your insurance company or access it via your online account through your insurance provider’s website.

Staying in network will save you money.

Visits to health care providers or facilities within your plan’s network are generally much cheaper than visits to out-of-network providers or facilities. The type of insurance policy you have plays a role in who participates in your plan’s network and how much you will pay if you choose to visit an out-of-network provider not covered by your plan. For example, HMO (Health Maintenance Organization) plans require you to select one primary care physician who will coordinate all of your health care services. With this plan, out-of-network providers are typically not covered at all, expect for true medical emergencies.

On the other hand, PPO (Preferred Provider Organization) plans allow you to visit any provider or specialist, in-network or out-of-network, and without a referral. Though your PPO plan may cover your out-of-network visit, you will pay more out-of-pocket for those services. Regardless of the type of plan you enroll in, be mindful of the providers in your network, as it can have a huge effect on your out-of-pocket costs.

All qualified health plans have cost-sharing limits.

All qualified health plans have an out-of-pocket maximum, which is the most you have to pay personally for covered services over the course of a year. All the money you pay for your deductible, coinsurance, and copays (but not premiums) goes toward your out-of-pocket maximum. Once you reach this limit, your insurance plan pays 100 percent for all covered medical services. Understanding how all potential out-of-pocket costs work together can be a little complicated, so here’s an example:

  • Suppose you are in a serious accident and have acquired $30,000 in medical expenses. Your health insurance plan offers a $2,000 deductible, 20 percent coinsurance, and a $5,000 out-of-pocket maximum for the year.
  • You would first be responsible for paying your deductible ($2,000).
  • After paying your deductible, you are responsible for your 20 percent coinsurance on the remaining $28,000 until you reach your out-of-pocket maximum.
  • Since 20 percent of $28,000 is $5,600, you would only be responsible for paying an additional $3,000 since your out-of-pocket maximum is $5,000. Your insurance plan would then pay 100 percent for all covered medical services thereafter.   

Be on the lookout for new resources from the National Consumers League (NCL) and America’s Health Insurance Plans (AHIP) to help consumers choose and get the most out of their health insurance benefits.

Five commonly asked consumer health insurance questions – National Consumers League

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doctor_patient_crop.jpgWith the Affordable Care Act (ACA) becoming law in 2010, more Americans now have access to health care coverage than ever before. However, many consumers are still puzzled about how to select a plan, what services are covered, or why they need health insurance altogether. If health insurance talk leaves you disillusioned or just plain confused, don’t give up. Below, we answer five of the most commonly asked consumer questions about health insurance. 

Why do I need health insurance?

It is in your best interest to have some form of health insurance. Why, you ask?

  • To protect your health
    While you may seem perfectly healthy now, sudden injuries or illnesses can occur in an instant. Without health insurance, you could be faced with thousands of dollars in medical costs, which could pose a significant financial burden well into the future. With health insurance, you also have access to preventive services such as physicals, immunizations, and other screenings that can help prevent diseases and identify problems earlier when they are easier to treat.
  • It’s required by law  
    Under the ACA, individuals are required to have health insurance (unless you qualify for an exemption). If you choose not to enroll, you will have to pay a tax penalty. 

How do I know what type of insurance plan is right for me and my family?

When shopping for a health insurance plan, here are some things to take into consideration:

  • Premiums: Each health insurance plan has a monthly premium that you must pay to maintain your coverage.  
  • Coverage/access to providers: Every plan has a different set of services, prescription drugs, and doctors that it agrees to cover. Every plan also uses a specific network of hospitals and health care providers to facilitate your care. Before choosing a plan, check that the services and prescription drugs you need are covered, and ensure that your current providers are within your plan’s network to avoid incurring additional costs down the line. 
  • Out-of-pocket costs: Out-of-pocket costs are health care expenses  you must pay yourself and that are not reimbursed by your insurance plan.

 Copayment, deductibles, coinsurance … What’s the difference?

  • A copayment or “copay” is a fixed amount ($10, for example) that you pay each time you visit a health care provider or fill a prescription.
  • A deductible is the amount you are responsible for paying for covered medical services before your health insurance plan starts to pay for covered medical expenses.
  • Coinsurance is usually a percentage of a total bill that you are responsible for paying after you’ve paid your deductible (for example, you pay 20 percent and your plan pays 80 percent). 

What is a health savings account, and what can I use those funds for?                                                                         

Health savings accounts (HSA) allow you to deposit pre-tax funds to pay for qualified medical expenses. They are typically combined with qualifying high-deductible health plans (HDHP). While HSA funds cannot be used to pay for monthly premiums, HSA-eligible HDHPs are attractive to many consumers because the premiums are generally lower. HSA funds can be used as needed to pay for prescription drug costs and fees such as copays, deductibles, and coinsurance. Learn more about health savings accounts here.

If my insurance company denies coverage for a service, is there anything I can do? 

If your insurance company does not authorize payment for a medical service, you have the right to appeal that decision. Before sending an appeal, carefully review your health coverage and the correspondence from your insurance company. Have copies of your medical records, letters from your providers, and any other pertinent information that supports your appeal. If your plan still denies payment of your claim after your initial appeal, you may opt for an external review conducted by an independent third party.

To answer questions like these, the National Consumers League (NCL) and America’s Health Insurance Plans (AHIP) are teaming up to provide consumers with even more helpful information about how to choose and use health insurance benefits.

 

 

Making the case for a soda tax – National Consumers League

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Last week the Center for the Science in the Public Interest hosted the National Soda Summit in Washington, DC. Strange name for a conference, I know.  Without further explanation, one might conclude from the title that his was a Coca-Cola extravaganza. Au contraire. CSPI, which was founded in by Dr. Mike Jacobson in 1971, gets the credit for getting Americans, for the first time, to question what’s in their food, ask how nutritional that food is, and ask why our food choices make us unhealthy.

Sweetened drinks such as soda, energy drinks, sports drinks, and sweetened coffees and tea, add large numbers of calories to the diets of children and adults. They are associated with chronic diseases, including type 2 diabetes, heart disease, and obesity.

Undoing the damage that’s caused by unhealthy foods – and the ubiquity of unhealthy drinks available to us every day –is a long slow process. Walk into a 7-11 sometime and count the number of empty calorie options that add massive amounts of calories to our diet every year.

On the tables at the conference were two-liter bottles of Mountain Dew and Pepsi and Coke and energy drinks– with notes on how much sugar each contained – try 64 teaspoons in the Mountain Due and 72 in the Pepsi. Bags of domino sugar were mounted on one table to demonstrate the absurd amounts of empty calories in these drinks. That’s a little bit deceptive because the sweetener in these drinks isn’t sugar but high fructose corn syrup. However, the calories are the same.

NCL supports a tax on sweetened drinks, with proceeds devoted to school nutritional education programs.  The latest research from the Robert Wood Johnson is that a calorie –based tax on drinks would reduce consumption of beverage calories. Based on sales data from supermarkets in New York, a .04 cent per calorie tax on sugar sweetened beverages would reduce the consumption of beverage calories by 9.3 percent. Research shows that a variety of pricing strategies can create incentives for healthier choices. Interestingly, a 20 percent increase in the cost of sweetened beverages, is estimated to reduce consumption by 24 percent. Like cigarettes, soda is price sensitive; raising the price of these empty calorie drinks may be just what we need to lower consumption levels.

 

Health IT: The next patient frontier – National Consumers League

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By Sarah Hijaz, Health Policy Intern

Modern technology has dramatically improved the way we communicate, connect, and learn. It is also beginning to improve the way we practice medicine and treat patients. On the 5th anniversary of the Health Information Technology for Economic and Clinical Health (HITECH) Act, which created a platform for health information technology to revolutionize our health care system, we are taking a look at what technology has and will do for our health care.

Health information technology (HIT) is the new driving force in the health care system. It allows health care providers to quickly search for patient records, have automatic filing systems, and in the future can create an inter-operable electronic database connecting patient records in real-time. Electronic health records (EHRs) present an amazing opportunity to advance care and improve health care provider workflow. For instance, EHRs make it easier to find out what tests have been ordered and medications prescribed by other providers. This cuts down on the chance of unnecessary, duplicate testing and inappropriate prescribing for medicines that should not be taken together.

Health IT also empowers patients.  Prior to the rise of electronic records, many patients, especially those unfamiliar with the healthcare system, thought that their health records were only for the health care provider. When in fact, your health record is yours—and patients should feel free to access it and know what information is in their record.  Now with EHRs, patients can go online and access their health information and make queries of the provider in real time. Some EHRs even allow patients to input information about their health to share with their doctor. By being able to quickly access and easily retain and send out copies of their EHRs, patients have a greater level of control of their personal information. In fact, a recent survey by the National Partnership for Women & Families has shown that 80% of individuals who have online EHR access take advantage of that access.

Consumer health advocates continue work on health coverage at the Families USA Conference – National Consumers League

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With only 60 days left for consumers to enroll in the Health Care Marketplace, I joined health care advocates from across the country to hear from healthcare experts at the annual Families USA conference.  Keynote speaker, Vice President Joe Biden, opened the conference with rousing words stating, “Now for the first time, health care coverage for all, is the law of the land.”

The law is a testament to the power of advocates and others, who worked tirelessly to secure this basic right for Americans.

Vice President Biden kicked off the conference with a challenge to remember what life was like before the passage of the Affordable Care Act (ACA) – when pregnancy was a pre-existing condition, young adults were kicked off their parents’ health plan, lifetime dollar limits were in effect, and patients could be denied coverage because of a pre-existing condition.  Americans no longer go to sleep at night worrying that if a family member gets sick, they might lose their house, their savings, and go bankrupt due to high medical bills and inadequate health insurance. “It is not just about physical health coverage anymore, but about peace of mind,” said Biden.

Many speakers, including Biden, noted that the conversation about health care has changed.  Instead of talking about health care as a privilege, it’s now agreed that health care is a right everyone deserves access to.  People who previously had no access to preventive care are going to the doctor and getting much needed care as a result of the ACA.

However, the conversation needs to shift to making sure this law works.  The current challenge, as we all know, is getting people enrolled.  As Ezra Klein of The Washington Post noted, “The problem will not be if the website is working properly, the problem will be that some people don’t even have a computer to access a website.” We will need to make sure those populations on the fringe are able to enroll and benefit from the health law.

Kentucky was held up as an example of what can happen when a state opens up its own exchange and recognizes the value of ensuring all its citizens have health insurance. Ranked at the bottom of most national health statistics, Kentucky decided that this was an opportune time to improve its citizens’ health by putting the people before politics. Kentucky is the only southern state to expand Medicaid and open a state-based exchange.  This decision meant providing coverage to nearly 640,000 uninsured people in the state. Expanding Medicaid allows those people who earn too much to qualify for Medicaid and too little to enter into the Marketplace access to coverage under the law. Kentucky Governor Steve Beshear stated that an independent analysis proved that expanding Medicaid will inject over $16 billion into Kentucky’s economy over the next 8 years and create at least 17,000 new jobs. It is clearly a win-win situation.

“The time for politics is over,” proclaimed Klein.  Over 3 million have signed up for private plans through federal and state exchanges as of January 24.  It is expected that a million more will be signing up in January.   As Biden noted, the “ACA is the most consequential piece of legislation” in decades.  Let’s make it work.

Cancelled policies, mandatory insurance, oh my! What consumers need to know about health care insurance – National Consumers League

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92_ayannaHealth care Marketplace exchanges went into effect on January 1. Since open enrollment began in October, 6 million+ people have enrolled for new coverage under the law. Enrollment is still ongoing, and if you sign up by January 15, coverage will be effective on February 1. Despite the good news, media attention to “Obamacare” has been mostly negative because of roll-out glitches with the site and health plan “cancellation letters.”

It is estimated that 4.7 million people have received cancellation notices, stating that their 2013 health insurance policies have been cancelled effective January 2014 because of Affordable Care Act (ACA) guidelines, according to a House Energy and Commerce Committee report. About half of those who received cancellation letters are now able to renew their prior coverage. As for the other half, the government estimates that roughly 10,000 will not have access to affordable coverage under ACA and will have to buy unsubsidized insurance on their own. The remainder, however, will be insured through expanded Medicaid, state or federal health exchanges, expanded age limits on parents’ plans for young adults under 26, or in purchasing a catastrophic coverage plan.

What hasn’t been covered in the media is the reason behind cancelling health insurance policies. These policies were cancelled because they do not meet minimum standards set up by the ACA for health insurance coverage. For example, prior to the ACA, it was legal for health insurance companies to exclude certain individuals from purchasing health insurance policies based on their preexisting conditions. Under the ACA, practices such as this are no longer legal. Additionally, all insurance policies must include certain “essential health benefits,” as defined by the Secretary of Health and Human Services. An example of an essential health benefit that is mandatory under the ACA is the complete coverage of all childhood and adult vaccinations. If an insurance policy does not meet the ACA’s minimum requirements, it must be modified so that it complies with the ACA or it must be cancelled.

The Confusion— On multiple occasions, President Obama asserted that, under the ACA, all Americans would be allowed to keep their insurance policies, if they were happy with them. However, the ACA states that if you are signing up for or renewing an insurance policy that does not meet minimum standards, it either must be modified to meet these standards or must be cancelled. Unfortunately, President Obama’s statement was not broad enough, and did not take these minimum standards into account.

The Fix— Health insurance companies may now continue to provide plans that do not meet ACA guidelines for an additional year. This is left up to the discretion of the state and if a policy remains valid, insurance companies have the right to keep or discontinue these policies. If a health insurance company renews a policy that does not meet ACA minimum standards, it is required to specifically inform customers about how these plans do not meet ACA requirements and of alternative ways of getting health insurance, such as through the Health Insurance Marketplace where customers might be eligible for lower cost plans.

There are still a number of options for consumers to get coverage, in the event of a cancelled or modified policy. It is strongly recommended that if your policy has been cancelled you shop around for other health insurance policy options before choosing any particular policy. There have been reports of cancellation letters that urge customers to sign up for “comparable” policies at the same health insurance company that are often significantly more expensive. The smart thing to do is to look at your options before signing up for any policy.

If your insurance company cancels your plan, your options include:

  • Buy one of the plans that the company offers in its place. It must allow you to buy any of its other plans available to you.
  • Buy a new plan in the Marketplace. You may qualify for lower costs on monthly premiums and out of pocket costs based on your income. Visit the Health Insurance Marketplace. Use this online resource to find out if you qualify for lower cost private health insurance plans or inclusion within Medicaid or the Children’s Health Insurance Program (CHIP).  If you are not qualified for these, the Health Insurance Marketplace is still a place to get insurance at a standard price.
  • Shop around for health insurance policies outside of the Health Insurance Marketplace.  This can be a good option if you don’t qualify for lower costs based on your income.
  • Buy a catastrophic plan. If your plan has been cancelled and you can’t afford a Marketplace plan to replace it, you can apply for a hardship exemption. This will allow you to buy a catastrophic plan. A catastrophic plan has lower premiums than a comprehensive plan but only provides coverage if you need a lot of care. This plan typically requires paying all your medical costs up to a certain point, which is usually several thousand dollars.

Big changes in health care this fall – National Consumers League

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This fall, there will be a new way to buy health insurance. NCL takes a look at what it means for you. October 1 marks the beginning of a new way to buy health insurance, put into place by the Affordable Care Act, or “Obamacare.” The ACA increases health care coverage for many Americans, even those who were previously underinsured or living without insurance.

Consumers can now buy health insurance on the Health Insurance Marketplace. Here, you can sign up for health care coverage and see apples-to-apples comparisons of costs and coverage between plans that fit your needs. Plans on the Marketplace will offer core set of essential health benefits like doctor visits, preventive care, maternity care, hospitalization, prescription drugs, and more

What: The Health Insurance Marketplace allows consumers to sign up for health care coverage and see apples-to-apples comparisons of costs and coverage to find the plan that is best for you. You can see what your premium, deductibles, and out-of-pocket costs will be before you make a decision to enroll. The Marketplace gives consumers control over their health insurance options.

Who: Some states run their own Marketplace. In other states the federal government runs the Marketplace.

When: Enrollment opens on October 1, 2103 and ends on March 31, 2014. Coverage begins as soon as January 1, 2014.

Where: Go to HealthCare.gov to get started. With the ACA, it is easier than ever to see if you qualify for insurance or other assistance programs, like CHIP or Medicaid. Just one application will let you know whether you can get lower costs based on your income.

Why: Before the ACA, more than 40 million Americans were uninsured. No one plans to get sick or hurt, but most people need medical care at some point.

How: The ACA gives everyone new protections, no matter what insurance they have. Now most plans can’t refuse coverage or charge more for pre-existing conditions like asthma or diabetes. Your plan can’t set a dollar limit on what they spend on your care during the entire time you are enrolled in the plan. Young adults can stay on their parents’ insurance up to the age of 26, and all plans must give a Summary of Benefits and Coverage, easy-to-read info about a plan’s coverage and costs. 

Beware of Fraud! Know the warning signs and how to protect yourself

With any new program, there is a lot of confusion around how it works or where to go for information. Sometimes consumers can become vulnerable to scams and fraud. With fraudulent websites or phone calls offering to help you sign up for “Obamacare,” it is hard to know who to trust. Here are some tips to protect yourself and personal health information from fraud.

  • Visit Healthcare.gov, the official site for the Marketplace, to sign up for coverage and learn more about the health care law.
  • Look for official government seals, logos or web addresses (.gov extension)
  • Compare insurance plans before making a decision or paying for insurance. There can be many that fit your particular needs!
  • No one should be asking for your personal health information. Don’t give it to anyone.
  • Keep personal and account numbers private. Don’t give your Social Security number or credit card or banking information to companies you didn’t contact or in response to unsolicited advertisements.
  • Never give your personal health or financial information to someone who calls or comes to your home uninvited, even if they say they are from the Marketplace.
  • Consumers should only get help to sign up for the Marketplace for certified application counselors and Navigators—check online for those organizations in your area approved by the government to help enroll individuals. These are free services provided to anyone who needs help. Beware of anyone who charges a fee in connection with enrollment.
  • Write down and keep a record of a salesperson’s name or anyone who may assist you, who he or she works for, phone number, street address, mailing address, email address, and website.

Learn more!

Online: HealthCare.gov | Call center: (800) 318-2596 | 24 hours a day, 7 days a week

TTY: (855) 889-4325

Information is available in dozens of other languages as well, including Spanish, Chinese, Vietnamese, and Korean. 

What health care reform means for young adults – National Consumers League

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The historic health reform battle ended in March, with the signing of the Affordable Care Act of 2010. While many of the law’s programs and benefits will be rolled out over the next 5-10 years, there will be several, more immediate, benefits that we will begin to see in the coming months.

You can actually see – state-by-state – which benefits have already been made available. It is now easier than ever to get access to health insurance.   Everyone will begin to see the benefits of the expanded access to affordable care – whether young adults, Medicare recipients, small business owners, or those just seeking additional preventive services.

What reform means for young adults

The new health care law enacted in March of 2010 has numerous provisions that will impact young adults. This demographic, though sometimes referred to as the ‘invincibles’, faces numerous health issues. The Department of Health and Human Services reports one in six young adults has a chronic illness and 30% are uninsured; young adults also have the lowest rate of access to employer-sponsored health insurance. The new law contains numerous provisions to cover young adults, whether through insurance provided through their employer, their parents’ health insurance, Medicaid changes, or the new Health Insurance Exchanges. Although many of its parts will not take effect until 2014, some major changes will occur in 2010.

Coverage

Before the law was passed, insurers could drop young adults from their parents’ health care plan when they turned 19, or upon graduation from college. The new law eliminates these practices. Starting in September 2010, dependent children up to the age of 26 will be eligible to remain on their parents’ plan, whether they are in college or not, living at home or residing in another state, or are single or married. The remaining exception, however, is that young adults offered coverage through their own job or if their parents’ existing plan does not qualify.

By 2014, all American citizens, including young adults, will be required to purchase insurance, with the threat of a fee for those who do not. There are various provisions in the new law, which make it easier to obtain coverage. Unemployed young adults with income up to approximately $15,000/year can look forward to an expansion of Medicaid for their health coverage. Individuals who make less than about $43,000 and who work at a place that does not provide affordable coverage can receive tax credits to help pay for insurance through new Health Insurance Exchanges. These exchanges will give consumers choice among plans and in a standardized format to help them find which is best for their needs. According to the Kaiser Family Foundation, prices each year will be capped at $5950 for individuals and $11,900 for families, excluding premiums.

The new law also intends to make obtaining insurance easier for young adults who work for small businesses. Many young adults work for small businesses. According to Kaiser Family Foundation, 36 percent of working uninsured young adults were employed in a small business with fewer than 25 workers. Incrementally over the next four years, small businesses with less than 25 employees will be eligible to receive tax credits to help make health insurance more affordable for their employees. If the small business has fewer than 100 employees, they also will be able to purchase insurance through the new Health Insurance Exchanges.

Preexisting conditions

Starting in September 2010, insurers can no longer deny coverage to children up to 19 with preexisting conditions such as asthma and high blood pressure. However, young adults over the age of 19 will not have this protection until 2014. In the meantime, adults with preexisting conditions who have not had insurance for a six–month period will have the option to either enter a temporary national pool for high-risk individuals or join pools set up by their state. You can find more information about whether your state is covered by this national plan here.

Preventive care

Under the new law, young adults can also take advantage of the many expansions to preventive care.  New health plans must cover certain preventive services without having the consumer share the costs.  Consumers will not need to pay a deductible, co-pay, or coinsurance when receiving preventive care. The preventive services covered include blood tests, many cancer screenings, and counseling for a wide array of issues.