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  3. 6 Things You Need to Know About Insurance

6 Things You Need to Know About Insurance

By Anne Kreuger
Updated February 26, 2021
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Here's what the Affordable Care Act means for your family's health insurance coverage.
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Health care overhaul

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Big changes are coming in the world of health care, with major portions of the Affordable Care Act (ACA) taking effect in January 2014. Learn how it'll affect you.

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You can't be turned down for health insurance even if you have a preexisting condition

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Starting in 2014, you can't be denied health insurance because you're sick or have a health condition. That means if you are obese, have delivered a child (yes, some insurers called that a preexisting condition) or have asthma, cancer, ADHD, diabetes—you name it—you won't be discriminated against when it comes to receiving medical coverage. (Read more about Health Insurance Horror Stories.)

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Finding affordable insurance should be easier

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Everyone will be required to have insurance under the new law or pay a fee. If you don't receive coverage through an employer, you'll be able to shop for a plan via the Health Insurance Marketplace—find your state's marketplace at Healthcare.gov. (Open enrollment began on Oct. 1, 2013, and runs through March 31, 2014, with coverage starting as early as January 2014.) Every insurance plan that wants to be part of the marketplace will have to offer the same essential health benefits, including preventive care, emergency services, hospitalization, mental health services and prescription drugs. You'll be able to compare plans and find the right fit.

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Most preventive care will now be free

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There are 22 preventive-care services provided specifically for women under the law, including mammograms, cervical cancer screenings and well-woman visits. Other covered preventive services include blood pressure, diabetes, depression and cholesterol screenings for adults, and vaccines and well visits for children. You pay nothing for these services—no deductible, co-pay or co-insurance.

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You can't be penalized for being a woman

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Research from the National Women's Law Center recently revealed that women are routinely charged more for health insurance simply because they are female. And individual health plans often exclude coverage for services only women need, such as maternity care. This will change in 2014, when maternity and newborn care will be required as part of the basic package of benefits that private insurers must offer in order to be listed in the marketplace. The practice of gender rating—charging a woman more just because she's a woman—will not be allowed.

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You're less likely to go bankrupt because of medical bills

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Since 2010, when the ACA was signed into law, insurance plans have no longer been allowed to limit how much they pay out to you for medical care during your lifetime. Starting in 2014, there won't be any dollar limits on what insurance plans will pay for essential health benefits during a single year, either. That will be a financial lifesaver for anyone who has a devastating and expensive health crisis.

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Your employer may still not provide coverage

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The ACA requires that employers with 50 or more full-time employees offer health insurance—or be forced to pay a penalty per employee. The original deadline for this mandate was January 2014, but it has been extended by a year. So if you thought you were going to get group insurance in 2014, it's important to know that the time frame has changed and you may be responsible for your own insurance in the coming year. (In fact, your employer may opt to pay the penalty rather than offer coverage in 2015.) If you need insurance, checking out the marketplace for your state is a good first step.

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1 of 7 Health care overhaul
2 of 7 You can't be turned down for health insurance even if you have a preexisting condition
3 of 7 Finding affordable insurance should be easier
4 of 7 Most preventive care will now be free
5 of 7 You can't be penalized for being a woman
6 of 7 You're less likely to go bankrupt because of medical bills
7 of 7 Your employer may still not provide coverage

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6 Things You Need to Know About Insurance
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