Frequently Asked Questions
The answer is not easy to give. For some people costs may go up, at least in the short-term. For others costs may go down or stay the same.
What is critical to understand is that the Affordable Care Act Health Care Reform sets a new minimum benefit standard for every major medical health insurance policy in the country.
Beginning in January 2014, any major medical plan sold must provide coverage for a minimum of 10 essential health benefits, including:
> Ambulatory patient services;
> Emergency services;
> Maternity and newborn care;
> Mental health and substance abuse
> Prescription drugs;
> Rehabilitative and habilitative services;
> Laboratory services;
> Preventive and wellness services and chronic disease management;
> And pediatric care.
And, the law requires that all of these benefits must be covered at a minimum of 60% of their actuarial value.
Youre probably wondering, What is actuarial value?
The easiest way to explain it is to say that it is a percentage of total average costs for covered benefits that a plan will cover.
So, a plan with 70% actuarial value would typically cover 70% of the costs and the customer would typically be responsible for 30% of the costs.