The enrollment period allowing individuals to sign up for health insurance through the Affordable Care Act (ACA) ends on March 31. Under the ACA, individuals must be covered this year or face a penalty of $95 per person or 1 percent of the individuals income, whichever is higher. Once the deadline passes, most people, with some exceptions, will not be able to buy a health insurance plan again until the next open enrollment period begins on November 15 for coverage that begins in 2015.
Sleep physicians must become familiar with this new insurance model, which will ultimately impact the types of care to which patients will have access. Members are invited to learn all about state or federally facilitated exchanges, the ACA and the AASM’s advocacy efforts in the new Affordable Care Act Resources section of our website. This also includes a series of helpful infographics on the changes, and exchange information for each individual state. We encourage you to spend some time with these resources.
Under the ACA, health plans must now:
- Cover 10 essential health benefits, including maternity care and mental health services;
- Offer coverage to all individuals, even those with a preexisting condition;
- Allow coverage for dependents up to the age of 26;
- Spend at least 80% or 85% of premium dollars on medical care;
- Provide a summary of benefits and coverage to all applicants and enrollees;
- Justify premium increases.