Individuals

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As a result of The Patient Protection and Affordable Care Act (PPACA), starting October 1, 2013 individuals in the state of Pennsylvania without health care coverage can begin shopping for affordable health care plans specialized to their individual needs and to those of their families.  The open enrollment period closes March 31, 2014, and those who are not covered by that time may be subject to a penalty. Coverage begins January 1, 2014 (1).

Insurance plans are offered by private companies, and offer what the PPACA calls essential health benefits, such as ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitation and habilitation services, preventative and wellness services, and pediatric services(2).

There are four tiers of benefit packages that are available.  The Marketplace plan tiers vary based upon costs paid by individuals out of pocket(3). Individuals and those who are self-employed may be eligible for tax credits and subsidies. To calculate your potential subsidy(4), click here.

No insurer can deny coverage or increase premiums because of an illness or pre-existing medical condition.  Health plans also are not allowed to charge women more than men(1).

Health plans that provide “minimum essential coverage” such as Medicare, Medicaid, CHIP, TRICARE, state-based risk pools and certain other government sponsored coverage are recognized by the department of Health and Human Services(5).

Many young adults up to the age of 26 are now eligible to be covered under their parents’ health plans if those plans include dependent coverage(6).  No one will be forced to relinquish their current job-based health care coverage(4).

The following flowchart from the Kaiser Family Foundation(7) explains many of the changes being enacted with PPACA.  If you cannot see the chart, click here.

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**Slate.com just released a story entitled More Good News for Obamacare—Evidence Premiums Will Be Cheaper Than Expected which claims that while premiums will vary significantly across the country, they are generally lower than expected, so some costs might be subject to change(8).

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Sources:

  1. https://www.healthcare.gov/what-is-the-health-insurance-marketplace/
  2. https://www.healthcare.gov/what-does-marketplace-health-insurance-cover/
  3. https://www.healthcare.gov/marketplace/individual/#state=Pennsylvania
  4. http://kff.org/interactive/subsidy-calculator/
  5. https://www.highmarkonhealthreform.com/forIndividuals/index.shtml
  6. https://www.healthcare.gov/how-does-the-health-care-law-protect-me/#part=1
  7. http://kff.org/infographic/the-requirement-to-buy-coverage-under-the-affordable-care-act/
  8. http://www.slate.com/blogs/moneybox/2013/09/05/kaiser_obamacare_premium_study_
    affordable_care_act_will_be_cheaper_than.html
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Gallery

August 4, 2017: Senator Blake joined a number of local officials to welcome Governor Tom Wolf back to Scranton to tour the success story that is the United Neighborhood Centers' community revitalization effort along Cedar Avenue in South Scranton. August 4, 2017: Senator Blake joined a number of local officials to welcome Governor Tom Wolf back to Scranton to tour the success story that is the United Neighborhood Centers' community revitalization effort along Cedar Avenue in South Scranton. August 4, 2017: Senator Blake joined a number of local officials to welcome Governor Tom Wolf back to Scranton to tour the success story that is the United Neighborhood Centers' community revitalization effort along Cedar Avenue in South Scranton. August 3, 2017: Senator Blake and State Rep. Mike Carroll joined Dupont resident Stanley Knick for his swearing-in ceremony to the Pennsylvania Board of Game Commissioners.

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