Health insurance is extremely beneficial to individuals who have been injured and are seeking compensation. Insurance will allow you to see a physician or therapy clinic at an affordable price, without having to utilize lien-based treatment. Health insurance companies will work with your medical providers to negotiate the bills on your behalf. Having health insurance will allow you to focus on the most important aspect of your case: Your Health.
At Fisher & Associates, our personal injury attorneys are here to help you understand the various nuances of your health insurance plan and how it may affect your case. Because we are currently in the Open Enrollment period for a 2016 plan, the attorneys at Fisher & Associates have provided the following information to help you navigate the healthcare waters.
In recent years, the laws and options for healthcare in the Unites States have changed drastically. The Affordable Care Act, or Obamacare, which was signed by President Barack Obama in March 2010, was created with three primary goals in mind: to improve the quality, increase the availability and lower the cost of healthcare for all Americans. Below are a few things you should know about the Affordable Care Act.
The Affordable Care Act (ACA) makes it a requirement that all citizens have health insurance.
The purpose of the Affordable Care Act is to ensure that all U.S. citizens have health insurance. For those who do not follow these guidelines, a heavy fine is enforced as penalty. In 2016, this fine will increase to $695 per person or 2.5% of a household’s annual income (whichever amount is greater). Do not become a victim of this penalty – see the list of important dates below to ensure you meet all deadlines.
The ACA requires all health plans to cover the 10 Essential Health Benefits.
- Outpatient care
- Emergency room visits
- Inpatient care
- Maternity services and care
- Mental health services
- Rehabilitative service
- Lab screenings and tests
- Wellness services
- Pediatric services for children
The ACA prohibits insurance companies from denying coverage, or charging more based on pre-existing conditions and health status.
Guaranteed Availability of Coverage means that you cannot be denied coverage for a reason consistent with previous medical history. Guaranteed Renewability of Coverage means that you will be eligible for renewal, regardless of previous medical conditions. Under these rules, the only way you can be denied is due to lack of payment.
Open enrollment is the only time that you can purchase private health insurance.
The dates of November 1 – January 31 are critical when it comes to purchasing health insurance. This is the timeframe in which you must purchase private insurance. The only exception to this rule is if you experience special circumstances, such as losing a job, getting married, or moving states, in which case, you may be eligible for a special enrollment period. Again, deadlines are extremely important when it comes to healthcare to ensure that you are not penalized with large fees or fines.
Beginning in 2016, large companies must provide health insurance to their employees.
In this case, a large company is defined as 50 or more full-time employees. This “Employer Mandate” states that, starting in 2016, companies who meet this criteria are required to provide coverage for each of their employees.
Below are a few important dates to consider when thinking about health care and the ACA this year.
- November 1, 2015– Open Enrollment began on November 1st, which means you can begin shopping for your 2016 health insurance.
- December 15, 2015 – This is your deadline to select the coverage that you would like to begin on January 1st.
- December 25, 2015 – This is your deadline to pay the insurance company for the coverage you elected to begin on January 1st.
- January 31, 2016 – This is the last day to apply for 2016 health insurance; if you miss this deadline, you could face penalties of a minimum of $695 per person.
If you have any questions about your health insurance coverage, or have been in an accident and require assistance getting compensated for your medical bills, do not hesitate to call the attorneys at Fisher & Associates. Our team is dedicated to providing you with the solutions you need to get back to your premium health and to receiving compensation for your injuries.