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Roxanne Stein: We have been hearing an awful lot about Obama Care for a long
time now. Open enrollment for the program's health insurance exchanges officially
gets under way next month, October 1st but you may be wondering what does all of
this really mean and how can it affect your health and your wallet. Here with
everything you need to know about this is Fox 29's lifestyle lawyer, Shari Olefson.
Shari Olefson: Good morning. Roxanne Stein: Nice to see you. Heck, we have
been talking about this it seems like forever. Nobody seems to understand this so
let's start with the basics. What is this insurance market?
Shari Olefson: Well that is really easy and we are going to drill down into this a little
bit more next week but while they are filibustering this in Washington this morning,
let's tell people what they really need to know. The market place is simple. It is a
website. It is a place that anyone who does not get insurance coverage from their
employer can go to, to shop, easily compare, and actually apply and enroll in one
place for their insurance. All your options are in one place. It will begin again...
open enrollment begins on October 1st. There are going to be four buckets Roxanne
so you can either choose a bronze, silver, gold, or platinum program and those
programs will determine how much you pay for your premium and what your
deductibles are or your coinsurance, how much of your services you pay for. The
market place will also tell you if you qualify for government assistance, helping to
pay your insurance and that will depend on how much money you make and the
size of your family and all you need to do is go to healthcare.gov. Now some of the
states are running their own marketplace but Florida happens to be one of 26 states
that is going to go with the federally run website, so Florida will not have its own
website. Roxanne Stein: So how is this health insurance
supposed to be better for all of us? Shari Olefson: That's easy. There are three
ways that most folks need to be aware of that this is supposed to be better than
what they have now. The first is what is called essential benefits. So there are certain
baseline of benefits that have not been required to be provided by all insurance
companies, preventive medicine, medical health services, and things like that
which will be now required from all healthcare providers, so that includes certain
doctor visits, hospital stays, and so on. The second is that those insurance companies
that were playing around with us, with denying preexisting conditions and
capping the amount of benefits we can get each year are no longer going to be able
to do that and then the third is the costs, there will be caps and limitations.
You are not going to be able to charge more for example because you are a woman.
Your insurance company cannot charge you more, so those are the things that
the new laws require.Roxanne Stein: So what do we need to know right now to take advantage
of these changes that are coming in a week?
Shari Olefson: Well the big thing for now is the dates. So the first date is October
1 st. Folks can go now to healthcare.gov and
just take a look at the website. All the functionality is not there yet but starting
on October 1st you will be able to go and apply. There is certain information that you
will need to enter, we will cover that next week, but I suggest that everyone go
and look at the website now so at least you know what is coming. If you apply and
you pay your premium by December 15th then you will have insurance coverage
by January 1st which is wonderful. Now open enrollment ends on March 31st, so if
you don't apply by then, unless you have what is called a qualifying event like a new
birth or something significant, you will have to wait until October to apply again.
The reason they do that Roxanne is so folks don't wait until they have a medical
emergency to apply for insurance because the whole point of this is that folks who
have not had insurance before and we have almost 4 million people in that bucket in
Florida, will get coverage but it is going to
even out the costs between people who had been paying more may pay less and
people who were paying less may end up paying more.
Roxanne Stein: Well we will let that be the last word until next week and then we
will talk a lot more about Obama Care. Thank you so much Shari for trying to hash
out a little bit about this and making some sense out of all of it.