Accessing Health Care
The Health Care Law and You
If you have private health insurance
Your insurance will not be dropped if you are diagnosed with psoriasis and/or psoriatic arthritis, or if you need expensive treatment.
Health insurance companies are no longer able to take away coverage after a person becomes sick or needs treatment—unless there is clear fraud, such as lying on your original application for insurance.
Your insurance company cannot stop paying for coverage when the cost of treatment reaches a certain dollar amount.
Lifetime limits on health insurance benefits were eliminated in 2010. Annual limits on the dollar value of coverage will be completely eliminated by 2014.
Starting in 2014, insurance companies will not be able to charge you more for coverage because of your psoriasis, psoriatic arthritis or other health status.
You have more resources to help with insurance appeals.
New consumer assistance are available, through improved state programs to help people with issues such as insurance appeals. Your State Insurance Commissioner is a source of information on where to get consumer assistance.
If you are on Medicare
As of 2010, Medicare patients have access to preventative care without copayments or deductibles.
The "donut hole" will be eliminated completely by 2020.
The period when the patient is paying 100% of the prescription cost is known as the "donut hole." This gap in prescription coverage will gradually be eliminated under the new law.
Medicare patients will continue to receive a 50% discount in 2012 on the cost of drugs when they reach the donut hole.
If you don't have insurance
People who have been uninsured for six months, and have a diagnosed pre-existing medical condition have new coverage options through transitional "high risk pools."
Currently 35 states operate high-risk pools. The federal health reform bill contains funding to expand the existing programs and support the creation of them in the remaining states. This is a temporary measure designed to help people get coverage now, until more comprehensive changes go into effect in 2014.
The cost to buy insurance is subsidized by the federal government. The yearly amount paid out-of-pocket for care will be limited to $5,950 for an individual and $11,900 for a family.
Learn more about the Pre-Existing Condition Insurance Plan.
Young adults up to the age of 26 can remain on their parents' individual or group health insurance policies.
If you're employed and your job doesn't offer insurance, you can be covered by your parents' insurance up to the age of 26. Both married and unmarried dependants qualify for this coverage
If you have a child who is uninsured, insurance companies are not allowed to refuse to cover children up to the age of 19 based on pre-existing conditions.
Beginning in 2014, you will be required to have insurance, except under certain circumstances.
Most U.S. citizens and legal residents will be required to have health insurance unless they qualify for an exception under certain circumstances (such as not being able to find a plan that is determined affordable).
Starting in 2014, if you do not have affordable insurance through your employer, you will be able to purchase it through new state-based "health insurance exchanges."
A "health insurance exchange" will allow you to compare plans that are comparable to each other offered by different health insurance companies. For example the most basic plan offered by any health insurance company will provide the same "essential benefits package" that covers basic medical services, including prescription drugs. More expensive plans will cover more services.
Beginning in 2014, financial help will be available and the amount of money you spend out of pocket will be capped.
If your income is:
- Less than 133% of the poverty level: You will be able to get Medicaid coverage, including if you are an adult with no dependent children.
- Between 133% and 400% of the federal poverty level: You will have access to financial help with the cost of health insurance on a sliding scale based on your income.
- More than 400% of the federal poverty level: Your annual out-of-pocket costs will be capped at $5,950 for an individual and $11,900 for a family.
Find out more about affordability subsidies that might be available to you »