All plans will cover emergency care, hospitalization, prescription drug coverage, mental health care and maternity and pediatric care. They also must provide preventive care such as routine vaccinations, mammograms and flu shots at no cost to the consumer.
One of the most significant aspects of the health exchanges being set up across the country is that, starting in 2014, having a pre-existing condition or being sick won’t keep people from getting health coverage. Insurers can’t jack up premiums or reject applications for coverage because of the applicant’s health condition. This applies even when the applicant has been rejected for coverage in the past.
Analysts who have been reviewing the premiums say that, in general, buyers who are younger and healthier will have to spend more for coverage than they do now. But coverage will be more affordable for people who are older and sicker.
In order to be covered by a plan by Jan. 1, consumers must enroll in a plan of their choice by Dec. 15.
Those who continue to stay uninsured after Jan. 1 face potential penalties of $95 or 1 percent of their income, whichever is greater amount. The fines will progressively accelerate each following year, rising to $695, or 2.5 percent of total income, by 2016.
Rebecca Lloyd, the vice president of Oneonta Block Co., said her company has been gearing up for months for the introduction of the Affordable Care Act, to ensure it complies with all requirements and to help company officials deal with the questions they expect to get from the firm’s 48 employees.
Lloyd said the company will continue to offer health coverage to its workers, though it will be up to those employees as to whether they want to go shopping on the New York State of Health exchange before deciding if they want to stick with the company’s coverage.