Individual plans

Many exciting changes are here with the adoption of Obamacare, also known as the Affordable Care Act.

Two major highlights:

  • You can no longer be dropped from coverage if you are sick.
  • You can’t be denied coverage for a pre-existing condition.

These and other protections are included in the Patient’s Bill of Rights section of the new law.


What is the purpose of the new law?

The Affordable Care Act seeks to make sure everyone has access to affordable health care and to bring down health care costs over the long run.

The most important thing to keep in mind is that this is a new law.  As with most new laws, there are implementation “glitches.”

Most coverage purchased today will not have an effective date until Jan. 1, 2014.  That means you have time to explore your options.  We suggest that you try to keep from being frustrated because the new law may really help you with your health care needs.


How can the new law help you?

Through the Affordable Care Act, consumers are able to make informed decisions about health insurance plans and receive comprehensive coverage in 10 areas.  Additionally if your family earns up to four times the poverty level, you may be eligible for cost subsidies to make health insurance more affordable for you and your family.

All health care plans have to offer coverage in ten essential benefit categories:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance treatment
  • Prescription drugs
  • Rehabilitative and habilitative services/devices
  • Laboratory services
  • Preventative and wellness services/chronic disease management
  • Pediatric services including dental and vision care

Why is this important?  Because now you can compare various health plans and compare them on an apples-to-apples basis.

What is the marketplace?  Should I use it?  And how do I find out about cost subsidies?

The federal government has set up a “Health Care Marketplace” for South Carolina residents.  It is a place where you can shop for health care coverage.   If you think you may be eligible for cost-sharing and premium subsidies, the marketplace is for you.

However, don’t be frustrated.  Due to implementation issues with the new law, it has been a challenge to access the marketplace.  Keep in mind, that any plan you sign up for now won’t have an effective date until Jan. 1, 2014.  You are not missing out if you don’t sign up today, but we can work with you to help you better understand your choices.

Can I shop for health care coverage off of the marketplace?

Yes.  In 2014, all plans, both on and off the Marketplace, are required to contain coverage in the 10 essential benefit coverage.  However, you will not be eligible for subsidies if you purchase your health care off of the marketplace.

Why should I use an insurance agent?

In some South Carolina counties, you will have 27 plans to choose from.  It can be very confusing to sort through.   It may not be in your best interest to pick a plan based merely upon premium. An agent can help you sort through your options.

Remember:  It costs you nothing to work with an agent. An agent is paid directly by the insurance company

Contact us today

We can help you find the best health insurance plan that fits your needs and budget.  Contact us today.