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FAQs About Obamacare

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With open enrollment underway, you are probably just now starting to consider how the Patient Protection and the Affordable Care Act (ACA), also known as Obamacare, will change healthcare for you and your family.

While certain groups are still debating the need and importance of this law, there is no longer a debate about whether ACA is a law or not.  It is a law, and everyone has the right to know about how ACA will benefit their healthcare and how to enroll or sign-up.

What does this mean for my family and community?

Our community faces serious health challenges such as heart disease, diabetes and obesity.  For African American women, although we are less likely to be diagnosed with breast cancer, we are far more likely to die from it.  As a group, African Americans are less likely to obtain preventive health care services but are much more likely to have chronic diseases, such as diabetes.

Currently, more than 6.8 million African Americans are uninsured.  ACA will give the uninsured access to affordable and comprehensive health insurance that will provide them with a full spectrum of preventive health services.  ACA mandates that preventive health services include screenings for blood pressure, Type 2 diabetes, HIV, cholesterol, breast cancer mammography, anemia and many more.  A full panel of immunizations will also be covered for children and adults.

How do I sign up for health insurance?

The answer to this question depends on which state you live in.  Some states have built and are managing their own “marketplace” or health insurance exchange for individuals and families to shop for and purchase their health insurance.  States that have decided that they are not establishing their own marketplace are being managed directly by the Federal Government.

No matter where you live, the easiest way to access information about obtaining health insurance through the health insurance exchanges is to visit www.healthcare.gov.

Once you enter your information, you will be able to find and compare prices of various health insurance plans and determine which is best for you and your family.  You will also be able to sign-up for health insurance directly online.  If you do have a computer, Internet access, or just feel more comfortable talking with someone directly, you can call the toll-free number at 1-800-318-2596.

Here’s a regional breakdown of which states have established health insurance exchanges and those managed by the Federal Government.*

State Run Health Insurance Exchanges By Region

NORTH

 

States Under the Federal Government Health Insurance Exchange By Region

NORTH

Illinois

Indiana

Iowa

Kansas

Missouri

Montana

Nebraska

North Dakota

South Dakota

Wisconsin

Wyoming

 

SOUTH

Alabama

Florida

Georgia

Louisiana

Mississippi

North Carolina

Oklahoma

South Carolina

Texas

 

EAST

Delaware

New Hampshire

New Jersey

Ohio

Pennsylvania

Tennessee

Virginia

West Virginia

 

WEST

Alaska

Arizona

Utah (For individuals only)

*If you are a resident of American Samoa, Guam, North Mariana Islands, Puerto Rico or Virgin Islands, you are not eligible to utilize the Health Insurance Exchanges to purchase health insurance and should contact your territory’s government to find out what health insurance options are available.

Does the government shutdown change any of this?

No, the government shutdown does not affect the ACA kickoff date or enrollment period.  The health insurance exchanges are open for you to start the process toward being insured.

How much will I have to pay for health insurance?

The new health insurance exchanges will help you choose the right plan for you and your family.  There will be four levels of plans: Bronze, Silver, Gold, and Platinum.  The Bronze plans will be the lowest cost plans with higher out of pocket expenses (you pay 40 percent of your healthcare costs) and the Platinum plan will provide the highest quality at the highest costs (you pay 10 percent of your healthcare costs).

Most Americans who utilize the health insurance exchanges to purchase their health insurance will be eligible for a tax subsidy from the Federal Government.  If you earn between 100 percent and 400 percent of the federal poverty level, you will be eligible for a tax credit.  This means that single people with incomes between $11,490 and $46,000; a two-person family with income between $19,530 and $78,120; and a four-person family with income between $23,550 and $94,200 per year would be eligible for a tax credit.  Your level of tax credit support will be determined when you apply for health insurance, and it can lower you monthly premium substantially.

Can I keep my current doctor?

Yes, but it may depend on the health insurance plan that you purchase.  This issue will be specifically important for individuals and families that are dealing with ongoing health issues and feel the need to maintain the physician relationship that they already have in existence.  For those who will be getting health insurance for the first time, you will still want to research physicians and make sure the physician you want is in the network of the health insurance plan you are purchasing.

Most health insurance plans have “networks” that include specific hospitals, doctors and pharmacies that have been contracted with to accept and treat patients who are part of that specific plan.  Before making the decision to purchase a specific plan you should contact your physician and see if they are part of the health insurance plans’ “network” that you want to purchase.  If they are not part of that “network,” you will have to decide to select another health insurance plan that they are part of to purchase or switch to a new doctor.

Over the next few weeks we will be back with suggestions on how to prepare for your interactions with your healthcare provider so that you can get the most out of your health insurance. You can also follow us on Twitter @ArtemisMedSoc.

Artemis Medical Society

(Doctors Naeemah Ghafur, Aletha Maybank and Myiesha Taylor contributed to this article.)

Artemis Medical Society is an organization of nearly 3000 physician women of color in the U.S. and around the world. Artemis Medical Society believes physician women of color are a vital part of an effective physician workforce that is responsive to, and aims to deliver quality healthcare to our increasingly diverse communities. From a social movement to a broader vision, Artemis Medical Society’s mission is to serve, nurture and celebrate a global sisterhood of women through mentoring, networking and advocacy. Learn more about Artemis Medical Society at www.artemismedicalsociety.org.