did we need the Affordable Care Act?

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1 WHAT NEW YORKERS NEED TO KNOW ABOUT THE AFFORDABLE CARE ACT did we need the Affordable Care Act? The high cost of health care is a burden on New York s families. The Affordable Care Act improves economic security by making health care more affordable. 2.6 million New Yorkers have no health insurance WAGES INSURANCE COSTS Health insurance premiums rose 7 times faster than wages The Affordable Care Act establishes a marketplace for health insurance that empowers consumers and brings down costs. The Affordable Care Act also The marketplace consolidates consumers purchasing power, so they can purchase coverage at wholesale not retail prices.? Consumers can get financial help through the marketplace and compare plans so they get the best deals for themselves and their families. levels the playing field for New York s families by improving insurance protections for consumers. Eliminates co-pays for preventive care Ends annual and lifetime caps on coverage Lowers prescription drug costs for seniors Ends denials of coverage for pre-existing conditions Taken together, these measures build economic security and peace of mind for our families. Prepared by the Community Service Society of New York WHY In the last decade

2 WHEN MARCH 2010 does the Affordable Care Act take effect? The Affordable Care Act (ACA) was signed into law. OCTOBER 2013 New Yorkers can enroll into affordable health insurance at NY State of Health: The Official Health Plan Marketplace. JANUARY 2014 Coverage begins through NY State of Health: The Official Health Plan Marketplace. OCTOBER 1 in e m co we re OPEN NY State of Health: The Official Health Plan Marketplace is open for business. The health coverage starts in January SINCE THE ACA WAS SIGNED INTO LAW: Parents can now keep their children on their insurance until age ,000 young adults in NY have already gained coverage The Medicare Part D donut hole is being phased out. New Yorkers with Medicare have saved over $516 million on prescription drugs Insurance plans must cover many preventive services for free. 4.4 million New Yorkers have gained free preventive services $$ $ Lifetime dollar limits on health benefits are banned. 6.4 million New Yorkers no longer have to worry about running out of insurance benefits if they get sick More than one million New Yorkers are expected to gain coverage.

3 WHO is the marketplace for? Anyone who does not currently have health insurance. Financial help may be available to help you purchase health coverage. Anyone who purchases health insurance as an individual, and not through a group or employer plan. The plans offered through the NY State of Health marketplace are likely to have significantly lower premiums and could provide better coverage. Anyone who is unsatisfied with the insurance coverage provided by their employer. However, if your current plan meets coverage and affordability requirements, you will not qualify for financial help on the marketplace. Small Businesses will also be able to select health plans for their employees through the Small Business Marketplace. 81% of small businesses in New York State are eligible for tax credits to help pay for this coverage. Everyone should go to the marketplace to see what it has to offer.

4 HOW much will it cost? YOU MAY BE ELIGIBLE FOR FINANCIAL HELP Family Size Maximum Income Medicaid Eligible Tax Credit Eligible $15,281 $45,960 $20,628 $62,040 $25,974 $78,120 $31,321 $94,200 $36,668 $110,280 $42,014 $126,360 You may qualify for FREE coverage You may qualify for financial help to lower your costs Insurance premiums on the marketplace will average 50% LOWER than private plans on the individual market To see what plans are available in your area and if you qualify for financial help visit: nystateofhealth.ny.gov There you can explore your options and estimate your monthly costs. What if I don t qualify for financial help? In most cases, you can still select a full-price plan from the NY State of Health marketplace. A variety of plans are available.

5 WHAT type of coverage is available? All health insurance plans will be required to cover a set of minimum essential health benefits H PREVENTIVE & WELLNESS SERVICES PRESCRIPTION DRUGS EMERGENCY CARE MENTAL HEALTH SERVICES A B REHABILITATIVE & AMBULATORY HABILITATIVE SERVICES PATIENT SERVICES LABORATORY SERVICES HOSPITALIZATION C PEDIATRIC CARE MATERNITY & NEWBORN CARE You can choose from a variety of plan types to meet your needs and your budget. PLATINUM GOLD SILVER BRONZE CATASTROPHIC (under 30 years old) $ Lower out-of-pocket costs Lower monthly premiums You can access both public and private insurance, depending on your income, at NY State of Health. 16 * private insurance providers will offer health insurance plans in the marketplace. If you qualify, you can also enroll in public insurance programs such as Medicaid or Child Health Plus. *Affinity Health Plan, Inc. American Progressive Life & Health Insurance Company of New York (Today's Options of NY, Inc.) Capital District Physicians Health Plan, Inc. Health Insurance Plan of Greater New York (EmblemHealth) Empire BlueCross and Empire Blue Cross Blue Shield Excellus (Excellus Blue Cross Blue Shield in Central NY and Univera in Western NY) Fidelis Care Freelancers Co-Op (Health Republic Insurance) Healthfirst New York HealthNow New York, Inc. (Blue Shield of NENY; Blue Cross Blue Shield of Western NY) Independent Health MetroPlus Health Plan (Market Plus) MVP Health Plan, Inc. North Shore LIJ Oscar Insurance Corporation United Healthcare of New York, Inc. (United, Oxford)

6 WHERE can I go to get coverage? nystateofhealth.ny.gov Starting on October 1, 2013, New Yorkers will be able to shop, compare, and enroll in a quality, low-cost health plan directly through the NY State of Health website. Coverage starts January, Create an Account Enter Household Information Enter Household Income Determine Eligibility - Financial Help - Medicaid Choose a plan and enroll YOU CAN ENROLL OR GET HELP IN 3 WAYS Online By phone Enroll at nystateofhealth.ny.gov and get live-chat assistance Call the NY State of Health customer assistance line In person Enrollment assistance is available in every county through Navigators or Certified Application Counselors The Community Service Society Navigator Network We offer free step-by-step assistance for individuals and small businesses enrolling in health insurance through the NY State of Health marketplace. Phone call us for an enroll@cssny.org Website cssny.org/navigator Learn more about the Affordable Care Act in New York visit cssny.org/healthcare