Get Connected. Get Covered. Affordable Care Act (ACA) 101 Enroll DuPage Navigators January 2014

Get Connected. Get Covered. The Affordable Care Act (ACA) improves how millions of Americans access health care and makes insurance more affordable. Marketplace Medicaid Expansion

Get Connected. Get Covered Young Adults in US Under the Affordable Care Act, up to 16.7 million of America’s 19 million uninsured young adults could be eligible for free or reduced cost coverage through expanded Medicaid (if all states expanded) or tax credits/cost sharing (via the Marketplace).

Get Connected. Get Covered Young Adults in Illinois

Get Connected. Get Covered Young Adults in Illinois

Get Connected. Get Covered. Medicaid Expansion Eligibility Benefits Funding

Status of State Medicaid Expansion Decisions, as of December 11, 2013 Implementing Expansion in 2014 (26 States including DC) Seeking to Move Forward with Expansion post-2014 (2 States) Not Moving Forward at this Time (23 States)

Get Connected. Get Covered. Improved Coverage No rule out for pre-existing conditions No lifetime caps Covered through parents up to age 26 or 30 years old if veteran Premium equality between genders 100% coverage of preventive services (no copays/coinsurance) Must include Essential Health Benefits

Get Connected. Get Covered Essential Health Benefits Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventative and wellness services including chronic disease management Pediatric services including oral and vision care

Get Connected. Get Covered. Preventive Care Benefits 1.Abdominal Aortic Aneurysm one-time screening 2.Alcohol Misuse screening and counseling 3.Aspirin use to prevent cardiovascular disease 4.Blood Pressure screening 5.Cholesterol screening 6.Colorectal Cancer screening 7.Depression screening 8.Diabetes (Type 2) screening (high blood pressure) 9.Diet counseling 10.HIV screening 11.Immunization vaccines for adults 12.Obesity screening and counseling 13.Sexually Transmitted Infection (STI) prevention counseling 14.Syphilis screening 15.Tobacco Use screening

Get Connected. Get Covered. Financial Assistance Premium Tax Credits – Up to 400% of FPL Cost Sharing Subsidies – Up to 250% of FPL Medicaid – Up to 138% of FPL

Get Connected. Get Covered. Individual Responsibility 2014 must enroll by 3/31/14 to avoid penalty – $95 per adult – $47.50 per child (50%) – Or 1% of family income, whichever is greater. Paid thru federal income tax

Get Connected. Get Covered Your Rights Under ACA The right to stay on your parents’ family health insurance plan until age 26. The right to coverage that cannot be dropped when an unexpected condition or accident makes your care expensive. The right to an appeal if coverage for needed care is denied by your insurer. The right to information about the cost of insurance and the quality of insurance benefits so that you can choose the plan that works best for you. The right to choose your own primary care doctor or pediatrician and to see an OB/GYN without a referral. The right to emergency care when and where you need it without huge out-of- pocket network costs. The right to a rebate if your insurer spends less than 80% of premium dollars on care. The right to free preventive care to keep you healthy and your health care costs down. The right to get covered, even if you have a pre-existing health condition. Source: Illinois Public Interest Research Group

Get Connected. Get Covered What Young Adults are Saying Source: Young Invincibles.org, 2013

Get Connected. Get Covered What Young Adults are Saying Source: Illinois PIRG, Health Insurance 101 Guide, 2013

Get Connected. Get Covered. Illinois Health Insurance Marketplace

Get Connected. Get Covered. What Can I Do on the Marketplace? Pay Initial Premium.

Get Connected. Get Covered. For Individuals Marketplace Plan Compare Sample Monthly PremiumDeductible Out of Pocket Maximum Copayments/ Coinsurance $x (# enrollees) $x/yr Family$x/yr Family Primary: $x Specialist: $x Generic rx: $x ER visit: $x $x/yr Individual $x/yr Individual

Get Connected. Get Covered What Young Adults are Saying

Get Connected Get Covered Call Center: Monday-Friday 8am-9pm; Saturday 8am-2pm