What do I need to know right now?

  • Dependents under age 26 may be eligible to remain on your plan. It will depend on whether or not the dependent is eligible for coverage through their own employer.
  • Children under age 19 cannot have insurance coverage denied or delayed because of pre-existing conditions.
  • Insurance plans must cover, at no out-of-pocket cost to the individual, qualified preventive services.
  • Your health insurance plan can no longer limit the amount of health benefits you receive over your lifetime. Annual limits on care are restricted.
  • Insurers cannot terminate ("rescind") existing policies except in cases of fraud, or where information that the insured individual provided in the policy application is intentionally misstated and that information affected a) the insurer's decision to issue coverage in the first place, b) the terms of the coverage issued or c) the premium charged.

What will happen to my premiums?

There's no simple answer - it depends on your insurance status and how much care you need. For some, the cost of health insurance will rise while others may see a decrease in their premiums. Whether or not an individual's plan is grandfathered will play a big factor in 2014.

We believe that the price of insurance on average will increase, especially plans for individuals and small businesses, as a result of certain provisions in the reform legislation. These provisions guarantee richer levels of benefits than most consumers buy today.

Insufficient discounts for the young and healthy will encourage many of them to forgo coverage and pay the penalty instead. New fees and taxes mandated by the new law will also likely increase the cost of premiums as they are phased in. For the millions of individuals and small employers who qualify for subsidies, what they actually pay for insurance themselves may not increase.

Why do health insurance costs continue to rise?

Some of the factors driving health insurance premiums:

  • Increasing use of the health care system due to an aging population, obesity and chronic illnesses
  • New treatments
  • Prescription drugs
  • Expensive new technologies

Changing the way medical care is paid for by insurers and government programs is considered to be the most effective way to address these factors.

While the new law establishes a few new programs aimed at these cost factors, the law doesn't aggressively attempt to control rising health care costs. How do medical costs affect what people pay for health insurance?

Where can I get health insurance if I don't currently have it?

Most health insurance carriers offer policies tailored to individual purchasers and families.

Learn more or get a free rate quote.

If you have been denied coverage because of a medical condition, in the short term, you may be eligible to buy health insurance through a state or federally subsidized high-risk pool.  Beginning in 2014, individuals will have the opportunity to buy insurance through state-run exchanges as well as from insurers directly or through insurance agents as they do today.

Why should I be required to buy health insurance?

For health insurance to work properly everyone must be in the system. This allows risk - and costs - to be spread across the sick and the healthy, the young and the old. The individual mandate is thought to be the easiest way for this to happen.

When people without insurance get sick or hurt, the cost of their care is paid by other users of the health care system and society in general. For example, emergency rooms can't turn away people who are unable pay, so everyone else ends up sharing the cost of this 'uncompensated care.' When the individual mandate is enacted, millions more people will pay into the system, so there will be more money available to pay for care when people need it.

Will the individual mandate actually work?

The insurance industry has long supported an individual mandate. Our biggest concern is that this individual mandate isn't strong enough. The new law calls for an annual penalty of the greater of $695 per person (up to a maximum of $2,085 per family), or 2.5 percent of household income. And it will be three years before the penalty reaches even that level. At that rate, we think millions of Americans will choose to pay that penalty instead of their premiums.

What are "exchanges" and how will they work?

  • Exactly how insurance exchanges will work is unknown at this time, but some people think the experience will be similar to how travel plans can be made on websites like Orbitz® or Expedia®.
  • People who use exchanges will be offered a choice of health plans at different price levels. Each exchange will set up rules and communication tools to help people make fair, accurate comparisons.
  • Individuals and small employers who are eligible for subsidies will only be able to claim them by purchasing coverage through an exchange.
  • At first, exchanges will serve individual people and small employers. Later, states will have the option of opening them to larger employers.