10 Facts You Need to Know About the New Health Law

8/7/2013, noon
President Obama signs the health insurance reform bill in the East Room of the White House on March 23, 2010. Photo by Roy Lewis

Here are 10 important facts that everyone should know about the new health law to make sure you enjoy the benefits of the law:

What are my rights under the law?

Insurance companies are not allowed to turn you down or charge you more because of a current or past medical condition like diabetes, heart disease, or cancer. And they must pay for care related to your condition. If you are a woman of child-bearing age, insurance companies can’t charge you more. And insurance companies cannot cap your benefits annually or have lifetime dollar caps.

What benefits can I get under the law?

Insurance policies must cover all essential health benefits including doctor visits, hospital stays, emergency room care, maternity and newborn care, prescription drugs and lab tests, substance abuse and mental health treatment. Preventive care including cancer screenings, immunizations, and well-baby visits are covered with no cost-sharing.

What is DC Health Link?

DC Health Link is a new on-line marketplace where you can shop for health insurance, compare policies side-by-side, and choose the policy that best meets your needs and budget. DC Health Link will help you find out if you are eligible for help paying your premiums and your cost-sharing expenses. If your income is low enough, it will get you enrolled in the District’s Medicaid program.

When can I enroll in health insurance coverage at DC Health Link?

DC Health Link will be open for enrollment on October 1, 2013. Individuals and families buying coverage after that date will have coverage on January 1, 2014.

Will I be able to get help shopping for health insurance?

Trained experts will be available to you – at no cost – to help you shop for health insurance and find out if you are eligible for financial help to lower your insurance costs. A telephone hotline will be open 24/7 and you can make an appointment to work with an expert in person. You can also work with an insurance broker.

Who is eligible for financial help to reduce monthly insurance premiums?

Many people will be eligible for help to pay their premiums when they shop at DC Health Link. Based on your income, you will know how much help you are qualified to receive. If your income is low enough, you will qualify for Medicaid at no cost to you. If you are buying private insurance, you are likely to be eligible for help paying your premiums based on a sliding scale if you are:

A single adult with income up to $45,960;

A family of two with income up to $62,040;

A family of three with income up to $78,120; or

A family of four with income up to $94,200.

Am I required to have health insurance?

Starting in January 2014, most people are required to have health insurance or pay a penalty to the IRS. Some people are exempt from this requirement including people who would have to spend more than 8 percent of their income to buy insurance and those with income below the threshold for filing taxes.