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benefits

Will ‘Gold’ plans sold in the exchanges offer more generous coverage? What exactly will a Gold plan cover that isn’t covered by Bronze or Silver plans?

Q. I have read that the “Gold” plans sold in the exchanges will offer “more generous coverage.” What exactly will a Gold plan cover that isn’t covered by Bronze or Silver plans? A. All plans (whether Bronze, Silver, Gold or Platinum) must cover the same 10 essential benefits while also offering free preventive care. To say […]

August 12, 2013

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Will Gold plans sold in the exchanges offer more generous coverage? What exactly will a Gold plan cover that isn’t covered by Bronze or Silver plans?

Q. I have read that the “Gold” plans sold in the exchanges will offer “more generous coverage.” What exactly will a Gold plan cover that isn’t covered by Bronze or Silver plans?

A. All plans (whether Bronze, Silver, Gold or Platinum) must cover the same 10 essential benefits while also offering free preventive care. To say that more expensive plans offer “more generous benefits” is misleading; they all provide comprehensive coverage. But plans with the lowest premiums (Bronze and Silver) require you to pay a larger share of the cost of those essential benefits. This means that your co-pays and deductibles will be higher.

August 12, 2013

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If my employer offers health benefits, can I still be on my parents’ plan?

Q. I am 24 and my employer offers health care benefits. But I would rather be on my father’s plan. Is that possible?
A. This year, you cannot enroll in a parent’s plan if your employer offers insurance. But beginning in January 2014, you can. You will be able to stay on your father’s plan until you turn 26.

May 14, 2013

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Is it true that under the ACA, insurers can’t cap how much they’ll pay out over the course of your lifetime?

Q. I have read that under the ACA insurers can not cap how much they will pay out over the course of your lifetime. Is this true? A. Not entirely. They cannot impose a limit on how much they reimburse for “essential health benefits.” (See a list of those benefits here.) But they can cap how much they will pay out over the course of a person’s lifetime for specific benefits that are covered under your plans but are not considered essential benefits.

May 14, 2013

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If someone decides not to buy health insurance in 2014 and is injured in accident, what happens?

Q: Under reform, when a person opts out of buying insurance, pays the penalty, gets in an auto accident (hits brick wall at his house) and goes to hospital emergency room (ER) – what happens?

A: When he goes to the ER, the ER is required by law only to “stabilize him.” This means putting him back together so that, as some doctors put it, he “can walk out the door under his own power.”

March 25, 2013

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Under healthcare reform, will all insurance plans cover maternity benefits?

Q. Under healthcare reform, will all insurance plans cover maternity benefits?
A. Almost, but not quite all.

December 19, 2012

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What is a ‘new’ health plan? I’ve heard that only ‘new plans’ will cover preventive care without co-pays.

If you bought insurance in the individual market sometime after March 23 2010, your policy is a “new plan.” On the other hand, if you have employer-based insurance that existed before March 23 2010, and your employer has made no significant changes since then, it is not a new plan. Rather, it is a “grandfathered plan.”

December 19, 2012

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Full speed ahead for Colorado health insurance expansion

Denver Post –The state will redouble efforts to prepare for 2014′s growth in Medicaid enrollment, and a consumer “exchange” – the Colorado Health Benefit Exchange – where citizens should find individual health insurance with affordable, uniform benefits, proponents said.

June 29, 2012

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same sex health coverage

HHS makes it easier for domestic partners

A HealthCare.gov update makes it easier to find health plans on the non-group market that offer coverage for domestic partners. It’s a great step forward, but there’s still much more the site can do.

February 12, 2012

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How to buy medical coverage

How to buy health insurance

Buying health insurance can be complicated, but like a lot of things, it’s easier if you break the job into smaller tasks and work your way through them.

January 30, 2012

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