Health Insurance - Decoding Obamacare

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With the sign up process starting for Obamacare this week, Argo Insurance prepares its customers to successfully make the change by decoding all the new healthcare system has to offer.

With the sign up process starting for Obamacare this week, Argo Insurance prepares its customers to successfully make the change. The new healthcare system is rolling out and many people are hungry for information on how it will work and to what degree they will be affected by it. First and foremost, the October 1st date is basically like opening day – the marketplace (an online hub where citizens can view healthcare plans laid out by various independent healthcare providers) is now available for people to peruse. So, what are the most important things to know before logging on? To start, know that the October 1st date is the beginning of a six-month period that ends on March 31st 2014, during which time you can sign up for the service. If you sign up, coverage will go into effect on January 1st 2014.

One element is that all of the plans on the marketplace (or exchanges) meet a minimum coverage requirement. Every plan will cover prescriptions, hospitalization, and maternal and pediatric care. The interesting part about this is that providers can offer additional services, as well. So, although some of it services fall under the blanket coverage in the essential benefits, others can be chosen at will in order to customize plans to each person, family or business.

When exploring the exchanges, individuals should be aware of the four plan brackets. There are four levels, Bronze, Silver, Gold and Platinum, which represent different cost structures in relation to out-of-pocket fees like co-pays, medications and deductibles. This is important because networks of doctors and hospitals will differ between the levels and a certain medication taken regularly by a patient could be priced differently within each structure. To find out if a specific doctor accepts exchange-based insurance, just check out the directory provided by the plans on the exchange. This directory is a requirement for all providers listed on the marketplace.

Obamacare can be of the most assistance to lower-income families, because there is cap on how much the plans on the exchange can cost. For example, the cap for an individual buying health insurance is $6,350; for families of 2 or more plans cannot exceed $12,700. The new healthcare system also offers subsidized coverage for low or moderate income earners. If eligible, people can earn a tax credit, which can be used immediately to reduce their premiums. Eligibility is determined based on each person or family’s gross adjusted income, which means that low-income individuals won’t have to pay more than a certain percentage of their annual income.

Obamacare also puts a stop to higher premiums or denied coverage for people with pre-existing conditions, making the push for every American to have healthcare even more integral. In fact, if individuals fail to have coverage by the end of 2014, they will be charged a penalty equivalent to $95 or 1 percent of their annual income.

One way to avoid this fee is to thoroughly explore the options for low and moderate income-earners, including Medicaid. Medicaid was originally intended to be expanded under Obamacare, but was left up to the states to decide whether or not to move forward with the expansion. As a result, 26 states have increased their Medicaid coverage, while the remaining states have not. In the participating states, Medicaid can apply to anyone under the age of 65 who earned up to 138 percent of the poverty level (which translates to about $16,000 for individuals or $32,500 for families).

Argo insurance offers plans on the exchanges and is eager to help customers make the transition smoothly, including helping them find subsidies if they apply. For more information on the new healthcare offerings, visit and explore the marketplace to find an applicable plan.

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Peter Georgiev
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