Affordable Care Act
Health Insurance Marketplaces Open in October
Be prepared to help your patients navigate the new system and get the health care they need.
The Affordable Care Act (ACA) affects primary care physicians and their patients through initiatives designed to expand the primary care workforce and make primary care services more accessible to the U.S. patient population. A significant piece of the ACA is about to take effect: The Health Insurance Marketplace, a one-stop shop for consumers to research, compare, and purchase comprehensive health insurance plans, opens for enrollment on October 1, 2013. However, research shows that most consumers – your patients among them – don't know much about it. As states begin to promote the Marketplaces, your patients may have questions for you.
As a family physician, you have the opportunity to help your patients understand and navigate the changing health care landscape. During patient visits, be prepared to discuss the insurance options available through the Marketplaces and encourage patients to make coverage decisions that are appropriate for their health care needs. To facilitate and supplement your conversations, the AAFP has developed the following FamilyDoctor.org patient education handouts:
Marketplace Insurance Cost
How much will Marketplace insurance cost?
Marketplace plans will be available at a range of prices. The plans are grouped into four price categories – bronze, silver, gold, and platinum – based on their monthly premiums and out-of-pocket costs. Patients with regular health care needs may benefit from a gold or platinum plan, which will have a higher monthly premium but lower out-of-pocket costs.
ACA: 2014 changes
What changes should patients expect in 2014?
- Low-cost coverage options will be available through the Marketplaces.
- All Marketplace plans must offer a comprehensive set of essential benefits.
- Plans can no longer deny coverage due to pre-existing conditions.
- People who don’t have health care coverage will have to pay a fee.
What essential benefits are covered under a Marketplace plan?
Essential benefits include:
- Maternity and newborn care
- Mental health care
- Preventive health care services
- Pediatric health care services
- Prescription drug coverage
ACA: IMPLEMENTATION MAP
How is the ACA being implemented in my state?
Get state-specific information that you can share with your patients, staff, and colleagues about ACA resources in your area. The ACA Implementation Map includes marketplace type and Medicaid expansion status, and links to state marketplace, Medicaid, and navigator websites for all 50 states.
Resources For Patients
Help your patients make informed decisions about the health insurance marketplaces with resources from FamilyDoctor.org.
- FPM: How Health Care Reform Will Affect Family Physicians
- Leader Voices blog: Do Your Patients Know How Health Care Reform Will Affect Them?