What is this new Health Care Exchange all about?

The health care exchange (a.k.a. the marketplace) is the centerpiece of the Affordable Care Act, an online marketplace where consumers can shop around for health care plans, just like auto insurance. A Copeland Insurance Group agent can help you navigate and find the insurance plan best for you.

The marketplace opens Nov. 15 and people will have until January 31, 2016 to pick up a policy if they want to escape penalties.

What is the penalty if I don't enroll?

Most people must have health coverage in 2015, or pay a penalty. If you don't have coverage, you'll pay a penalty of either
2% of your household income, or $325 per adult ($162.50 per child under 18). The maximum penalty per family is $975.

2016, it rises to $695 per individual or 2.5 percent of income. For a family, the tax rises to $2,085 or 2.5 percent of income.

If you have a life changing event, you may qualify for a special enrollment period.

What is the core package of health benefits?

The law ensures that health plans offer a core package of items and services, known as "essential health benefits." They must include items and services within at least the following 10 categories:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative and habilitative services
  8. Laboratory services
  9. Preventive and wellness services
  10. Pediatric services, including oral and vision care

What are the new options for young adults?

The Affordable Care Act allows 2.5 million young adults, who can't get coverage through their job to stay on their parent's health plans until the age of 26.

What's the benefit for seniors?

The law protects any cuts to Medicare's guaranteed benefits, which include doctor, hospital and rehabilitation services.

Adds free preventive care services:
  • A yearly wellness visit
  • A 50% discount on covered brand-name medications
  • Preventative Screening (includes mammograms and colonoscopies)
  • Improved access to primary care doctors