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The Patient Protection and Affordable Care Act. Health Care Reform. Have you heard?. The New Health Law. OBAMACARE. The Patient Protection and Affordable Care Act. Have you heard?. The Patient Protection and Affordable Care Act. Have you heard?. - PowerPoint PPT Presentation
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THE PATIENT PROTECTION AND AFFORDABLE CARE ACT
Community Health Initiative of Kern County
HAVE YOU HEARD?
Health Care Reform
OBAMACARE
The New Health Law
Community Health Initiative of Kern County
HAVE YOU HEARD?
The Patient Protection and Affordable Care Act
Community Health Initiative of Kern County
HAVE YOU HEARD?
The Patient Protection and Affordable Care Act
Community Health Initiative of Kern County
HAVE YOU HEARD?
The Patient Protection and Affordable Care Act
PATIENT PROTECTIONS
Community Health Initiative of Kern County
PATIENT PROTECTION1. Cannot be denied coverage due to a pre-
existing condition.2. Able to maintain coverage for young
adults.3. Ends lifetime limits on health coverage.4. Restricts or eliminates annual limits on
coverage5. Provides preventive services at no cost.
Expanded preventive services are offered to women
Community Health Initiative of Kern County
PATIENT PROTECTION6. Does not allow premium increases without
justification.7. The majority of the expenses must go
towards medical costs.8. Cannot cancel coverage due to errors on
the application.9. Requires an easy to understand explanation
of benefits and coverage.10. Essential benefits AND MORE!
INDIVIDUAL MANDATE
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
Most U.S. citizens and legal residents must have health
insurance or pay a fine.
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
2014 2015 2016
For every uninsured adult $95 $325 $695
For every uninsured child $47.50 $162.50 $347.50
Or a percentage of your income, whichever is greater
1% 2% 2.5%
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATEWho is exempt? Persons with a religious objectionUndocumented immigrantsIncarcerated personsMembers of Indian Tribes If your household income is so low that you are not required to file an income tax returnIf buying health insurance is too expensive
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
There are options!
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
My employer offers me health insurance.
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
My employer does NOT offer me health insurance
and My total household income is less
than 138% of the Federal Poverty Level
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
My employer does NOT offer me health insurance
andMy total household income is less
than 400% of the Federal Poverty Level
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
My employer does NOT offer me health insurance
andMy total household income is more
than 400% of the Federal Poverty Level
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATEWho is exempt? Persons with a religious objectionUndocumented immigrantsIncarcerated personsMembers of Indian Tribes If your household income is so low that you are not required to file an income tax returnIf buying health insurance is too expensive
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
My employer offers me health insurance.Coverage must be:
1. Affordable2. Adequate
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
My employer offers me health insurance
butthe coverage is NOT
ADEQUATE.(on average, it pays less than 60% of medical
costs)
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATE
My employer offers me health insurance
butthe coverage is NOT
AFFORDABLE.(I have to pay more than 9.5% of my income in
premiums)
Community Health Initiative of Kern County
THE INDIVIDUAL MANDATEYour options:1. Employer sponsored health insurance2. Medi-Cal3. Covered California with Premium Assistance4. Covered California without Premium
Assistance
Enrollment closes March 31st, 2014
Community Health Initiative of Kern County
661-632-5018
WE’RE HERE TO HELP!
Community Health Initiative of Kern County
EXPANDED PREVENTIVE SERVICES FOR WOMEN
Anemia screening Breast Cancer Genetic Test Counseling Breast Cancer Mammography screenings Cervical Cancer screening Contraception Domestic and interpersonal violence screening Gestational diabetes screening HIV screening and counseling Osteoporosis screening Tobacco Use screening and intervention
Community Health Initiative of Kern County
ESSENTIAL HEALTH BENEFITS
Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use
disorder services including behavioral health treatment
Prescription drugs
Community Health Initiative of Kern County
ESSENTIAL HEALTH BENEFITS
Rehabilitative and habilitative services and devices
Laboratory services Preventive and wellness services
and chronic disease management Pediatric services including:
Oral Care Vision Care
Community Health Initiative of Kern County
MEDI-CAL
Family Size Adults(138%)
Children(250%)
1 $15,971 $28,7252 $21,559 $38,7754 $32,582 $58,6007 $47,361 $89,025
Community Health Initiative of Kern County
COVERED CA WITH PREMIUM ASSISTANCE
Family Size Household Income up to:
1 $45,9602 $62,0404 $94,2007 $142,440
Community Health Initiative of Kern County
COVERED CA WITHOUT PREMIUM ASSISTANCE
Family Size
Household Income Greater than:
1 $45,9612 $62,0414 $94,2017 $142,441
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