Category: Health Insurance Reform

Each state may choose to operate its own Marketplace and to expand their Medicaid program to serve low-income individuals and families. More than half the states have expanded Medicaid to serve low income families and individuals.

The name “Affordable Care Act” (ACA) is the name used to refer to the final, amended version of the comprehensive health care reform law and its amendments. The law addresses health insurance coverage, health care costs, and preventive care.

The Health Insurance Marketplace is a resource where individuals, families, and small businesses can compare health insurance plans for coverage and affordability; get answers to questions about your health care insurance; find out if you are eligible for tax credits for private insurance or health programs like Medicaid or the Children’s Health Insurance Program (CHIP); enroll in a health insurance plan that meets your needs.

No employer has to offer coverage. Some large businesses that don't offer coverage meeting certain standards may have to make a shared responsibility payment in 2015.

Yes. The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage. The law requires that most individual and small employer health insurance plans, including all plans offered through the Health Insurance Marketplace cover mental health and substance use disorder services.

Flu and other vaccines are required to be covered by your health insurance without charging a copayment or coinsurance. But, be sure to check with your insurance company to find out if you must go to a specific facility to receive the vaccine.

Yes. Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men.

Yes. Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men.

Yes. You can get dental coverage in the Health Insurance Marketplace in two ways: as part of a health plan, or by itself through a separate, stand-alone dental plan.

Bring your complaints first to your doctor and nurses. If you have Medicare, you can file a complaint with your State's Quality Improvement Organization. Talk to your hospital social worker if you believe you are not ready for discharge from the hospital. Billing complaints should be discussed with the hospital or Medicare carrier.

Families who earn too much to qualify for low-income Medicaid insurance may be able to qualify for the State Children's Health Insurance Program (SCHIP). The Centers for Medicare & Medicaid Services administer funds to States who are responsible for the program at the local level.

Free or reduced cost prenatal care may be available. Call 1-800-311-BABY to find the health department in your area code.

Consult the HHS Health Resources Services Administration (HRSA) directory of health centers at http://findahealthcenter.hrsa.gov/ - these health centers provide care on a sliding fee scale so it is affordable for anyone. You can receive care even if you are uninsured or cannot pay. Search the directory by zip code to find the centers nearest you.

Black Lung Clinics in 11 states provide services to active and retired coal miners with respiratory and pulmonary impairments.

About 300 health care facilities nationwide are obligated to provide free or reduced-cost care (called Hill-Burton Facilities). You must apply for assistance at the facility.

To find detailed information about the past performance of Medicare and Medicaid certified nursing homes, visit the Nursing Home Compare site. You can search by state, county, city, zip code, and/or facility name. See: http://www.medicare.gov/nursinghomecompare/search.html

Visit the Hospital Compare site (http://www.medicare.gov/hospitalcompare/) for data, then talk to your doctor and other health care providers about the quality and experience of hospitals treating the conditions you are concerned about.

Hospital Compare offers the consumer information on hospitals performance on measures of quality. Some information is based on how well hospitals provided recommended and appropriate care to patients being treated for heart attack, heart failure and pneumonia, or who were receiving surgical care.

There are a variety of resources for dental care, including local health departments, medical insurance programs (public and private), dental schools, clinical trials and state and local resources.