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In addition to the nationwide health plan marketplace, several states have created their own coverage databases to exclusively assist state residents in procuring a health plan. The following states offer their own healthcare exchange websites; all other states rely on HealthCare. For instance, bronze plan-holders pay the lowest premium of all four metal plans but also face higher deductibles and out-of-pocket costs.
Platinum plan-holders, on the other hand, pay the highest premiums in exchange for lower deductibles. Generally speaking, bronze and silver plans are best suited for young, relatively healthy individuals who do not require frequent physician visits, while gold and platinum plans are the best option for individuals with consistent medical needs. As stated above, the open enrollment period for individuals seeking health coverage in ended on December 15, When the next open enrollment period kicks off in the fall exact dates TBD , individual coverage seekers can obtain plans by:.
Regardless of the format one uses to obtain a health plan, he or she need the following materials in order to complete an application:. As mentioned above, individuals and families who fall within a certain income bracket qualify for tax subsidies from the federal government. Eligible individuals and families who purchase a plan through the marketplace within the open enrollment period and do not qualify for an employer-sponsored or federal health plan, meet the income criteria, and cannot be claimed as dependents may be eligible for the Premium Tax Credit.
Just as some individuals who purchase a health plan from the marketplace qualify for certain savings benefits, those who do not purchase a health plan within the open enrollment period and remain uninsured are charged a financial penalty. Individuals who had not obtained insurance for received the higher of the two following penalties:.
Uninsured individuals must obtain coverage of some sort, but they are not required to obtain a plan via the marketplace and may opt to shop for policies with providers who are not listed on the exchange.
Understanding the Affordable Care Act
Furthermore, a penalty is not given to individuals who are covered under the following plans and choose not to obtain coverage from a marketplace-based provider:. Additionally, some people may apply for an exemption for health insurance. Those who receive this exemption are not required to pay the penalty fee. Exemptions may be awarded to individuals under the following circumstances:. Click here to see the full list of healthcare exemptions and learn how to apply.
Finally, please note that certain health plans do not satisfy the requirements of the ACA. In these cases, plan-holders may be penalized even while receiving coverage:. Historically, Medicaid has only been available to children and their parents, disabled individuals, and the elderly. Adults with no dependent children, on the other hand, did not qualify for Medicaid.
Furthermore, eligibility for parents was relatively limited and varied on a state-by-state basis. The ACA was designed to reduce the coverage gap for these individuals by providing Medicaid to all persons who fall within certain income brackets, regardless of whether or not they have children. However, a Supreme Court ruling in allowed some states to opt out of the Medicaid expansion altogether.
In the 18 states that opted not to expand Medicaid or are currently debating the issue, parents are eligible for Medicaid at variable rates in relation to the FPL, while individuals without children are not eligible for Medicaid. To learn the current status of state Medicaid expansion decisions, see this map of data compiled by the Kaiser Family Foundation. Here are three factors to seriously consider:. The three overarching goals of the ACA are to ensure more people can purchase affordable health insurance, to provide greater coverage to children and adults through the Medicaid program, and to reduce the cost of healthcare.
Obamacare, a term often used interchangeably with the Affordable Care Act, is simply another name for the same piece of healthcare law. The term came to prominence as Republican congressional leaders tried to saddle the president with responsibility for the law if it proved a failure. Some specific goals of the PPACA include working to improve long-term care services, quality of care, delivery systems, and access for more Americans.
The number of people on Obamacare has grown significantly since the legislation first passed. Prior to the ACA being enacted, 48 million Americans were without health insurance. As of , that number had shrunk to Use the list as possible employment targets, but also as an example of how to research their employee benefit offerings. Others in hyper-competitive industries purchase an infertility rider voluntarily to attract and retain personnel. Some employers offer a hidden form of financial assistance. An FSA makes treatments much more affordable.
The federal government is the largest nationwide employer in the United States. The U. The OPM voluntarily offers benefits not required by law. The federal government employee health insurance plan offers the required benefits for ART to employees working in legal directive states. It does this to stay on par with private industry employers.
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In addition, the federal plan covers the diagnosis and selected treatments of infertility for employees working in non-mandate regions. It does this in order to compete for skilled workers. The state government is the next large public employment sector that might offer medical insurance covering IVF and other infertility treatments. Of course, state government by definition does not employ many people nationwide.
Therefore, the breakdown works differently. Joining the military is an option to obtain medical insurance covering ART — with limits. Military service members and their families may be eligible for one of three programs.
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Read the list of included and excluded services for each plan very carefully before deciding to enlist. Employers in private industry sometimes offer health insurance covering infertility or IVF treatment. They provide coverage when subject to a legal requirement. In addition, those in industries with high-demand skilled workers often purchase riders in order to compete for effective personnel. Boeing employs , people nationwide concentrated in ten different states. Boeing headquarters Washington State and may write their policy under these laws.
Washington State does not have a legal directive and the Boeing benefits for assisted reproduction reflect this. The plan will pay claims for the following services in connection with the diagnosis and treatment of infertility. Costco employees , retail workers in stores across the country. Costco also headquarters in Washington State no mandate and the in-network plan for full-time employees follows suit.
Understanding the Affordable Care Act
It does not pay for any infertility procedure including IVF except the diagnosis and treatment of the underlying medical condition. The Disney Company employs , people in 40 different countries. It is very difficult to provide a single reliable answer to their coverage for infertility or IVF. However, the factors making it so hard to determine may help readers learn how to spot other prospective employers with the coverage they want. Federal Express FedEx employs over , team members globally.
It is also very difficult to determine their coverage for IVF or infertility treatment. The Fedex headquarters are in Tennessee, which does not have a mandate. Hobby Lobby is a large Arts and Crafts retailer with stores across the country.
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The Hobby Lobby headquarters are in Oklahoma, which does not have a legal directive. Hobby Lobby is a secular company espousing Christian values.
It famously filed a Supreme Court challenge to Obamacare birth control requirements — citing religious objections. Therefore, it is unlikely that their health care offering covers IVF due to the inherent destruction of embryos. Starbucks is a large nationwide coffeehouse chain, also based in Washington State, which has no mandate. The voluntarily offer this rare employee benefit in order to attract and retain baristas. The UPS plan for retired employees echoes the established pattern.
However, no procedures and services, including lab and X-ray, intended to induce pregnancy rather than to treat an underlying medical cause are covered. Walmart is a big box retailer based in Arkansas — an IVF mandate state — with stores throughout the country. However, the Health Savings Account offered to store personnel explicitly excludes coverage for infertility treatment of any kind.
Walmart employs a large number of low-skill and part-time personnel. They have little incentive to pay for expensive elective services. Blue Cross Blue Shield is a national federation of affiliated enterprises using this trade name. BCBS is actually thirty-seven different independently operating organizations rather than one. Many affiliates write policies in a single state, while others serve wide regions.
Multiple Blue Cross Blue Shield affiliate companies create another layer of confusion.
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They often operate under a different name. Here is a partial list of these organizations. Each BCBS affiliate operates as an independent insurance company. Other private companies work in a similar fashion — just with a different brand name. They offer Medicare supplements, Medicaid programs, employer group, and individual policies. Medicare is a public health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.
They fill the gaps in Parts A and B. Medicaid is a public health insurance program that provides basic support for low-income families. You must meet income and asset means testing to qualify. Medicaid does not pay claims for any ART procedures. Regional legal directives do not apply to publically funded programs. Medicaid offers basic support only. Medicaid does cover pregnancy and sometimes pays for dental work and eye care. Medicaid programs also have many confusing name variations. Some states assign unique consumer-friendly monikers BadgerCare, Family Care, etc. In addition, private companies issue and manage Medicaid compliant programs.
The other private insurance companies will not pay for any Assisted Reproductive Technology ART for a policy individual or group absent a legal dictate or an employer requiring the benefit. These requirements pertain to plans rather than companies.