Top 5 Things Kidney Patients Need to Know About Healthcare Reform

Patient-Centered Research Opportunity - National Kidney Foundation

Top 5 Things Kidney Patients Need to Know About Healthcare Reform

Posted on June 24, 2013 by nkf _advocacy

1. On January 1, 2014 everyone is required to have health insurance. The Federal Government has a website where you will be able to shop for new options for health insurance beginning this October. Tax credits and subsidies are available for certain income levels to help pay premiums and limit out-of-pocket costs. In addition, there will be a maximum on the amount you have to spend on copays, coinsurance and deductibles no matter how many health services you end up needing (in 2014 this maximum will be about $6,350 for an individual and $12,700 for a family).
2. Insurers will no longer be able to deny you coverage if you have a pre-existing condition. So if you have chronic kidney disease you can get health insurance beginning January 1, 2014.
3. If you are on dialysis and covered by Medicare your coverage will not change. But if you are under 65 and receive a transplant you will be able to more easily purchase health insurance once your Medicare coverage expires 36 months post-transplant, even if you are unemployed or your employer does not offer health insurance. Also, if you have Medicare Part D and often reach the coverage gap (a.k.a the donut hole) the portion you have to pay in that gap will be lowered each year until eventually the gap is completely eliminated in 2020.
4. Assistance to purchase health insurance is available. If you make 400 percent of or below the federal poverty level (400 percent is approximately $94,200 or less for a family of four) and do not qualify for other health insurance (like Medicaid), you may be eligible for an advanced tax credit to help you pay your premiums. If you make between 100 percent and 249 percent of the federal poverty level, you may qualify for additional assistance to lower your out-of-pocket costs for healthcare services.
5. No need to wait! You can prepare for enrollment now. Visit www.healthcare.gov to learn more.
Do you have more questions or have you heard statements and descriptions about the health care law that you want fact checked? Send us your questions and our experts will give you the facts!

What is Healthcare Reform (a.k.a Obama Care) and what does it really mean for me?

On March 22, 2010 President Obama signed into law the Affordable Care Act. In addition to offering patient protections such as banning insurers from refusing to cover individuals with a pre-existing health condition or charging them significantly higher premiums, and stopping the practice of life-time and annual caps on health insurance benefits, the law requires every American have health insurance or pay an additional tax if they do not enroll in a plan. To make health insurance more accessible and affordable to individuals and small businesses, the law created Health Insurance Marketplaces and will provide subsidies to individuals who qualify so they can purchase health insurance. Each state has the option to establish and run their own Marketplace, work in partnership with the Federal Government, or leave establishment and management of the Marketplace completely in the hands of the Federal Government.

The Marketplaces will offer online enrollment and comparison-shopping so consumers can choose the plan that best meets their needs. In addition, trained navigators, in-person assistance personnel, and certified application counselors will be available in many local communities to assist individuals with comparing plan options and enrolling in coverage. The law also provided additional federal government funding to states to expand their Medicaid programs so that more low-income individuals will have affordable access to health care. However, not all states have elected to expand their programs, which will leave many individuals in those states uninsured. For those that remain uninsured, federal funding to community health centers was increased so that these entities could expand to offer services to the insured and uninsured.

Beginning in October 2013, individuals and small businesses can begin shopping for and enrolling in health insurance. All individuals will need to complete an application to see what financial assistance they qualify for. When individuals complete the application they will also be evaluated to see if they qualify for Medicaid. If they do not, they will be presented with other options for health insurance to choose from.

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