Obamacare or Affordable Care Act is the newly introduced act introduced by President Obama. The Act
is all about a new set of rules that change and dictate the way businesses administer, deliver, and
manage employee benefits. It is designed to offer Americans an affordable access to quality
healthcare. The Act is expected to exponentially decrease the overall growth of healthcare spending
Obamacare regulates health insurance and covers reforms such as consumer protection, regulations,
taxes, subsidies, and insurance exchanges. It may or may not replace the need of private insurance
such as Medicare.
Improving affordability, quality, and accessibility of quality healthcare, Obamacare offers
numerous advantages. However, its rules can be a bit complex to understand and implement properly.
That is why The Jordan Insurance Agency offers expert consultancy services that cover all the
aspects of Obamacare. We help you acquire control of the required action and fulfill ACA compliance
Understanding the Levels of Coverage
Due to varying needs and requirements, ACA offers four different levels of coverage each with a
different actuarial value i.e. the percentage of expenses that will be paid by the plan. These
levels are referred to as the Metal Levels due to their names; Bronze, Silver, Gold, and Platinum.
The highest tier, Platinum, covers almost 90 percent of the service with the plan holder paying
only 10 percent. The bottom tier Bronze offers the most streamlined coverage i.e. 60 percent of the
total healthcare expense. Plan holders pay the highest out-of-pocket amount that includes
deductibles, copayments, coinsurance, etc.
The percentage of expense covered by each level is as below.
- Bronze – 60%
- Silver – 70%
- Gold – 80%
- Platinum – 10%
The premium of the plan goes up from bronze to platinum. Apart from the level of the plan, monthly
premium also depends on various factors including the age, marital status, number of people
enrolling and the insurance company.
No matter the metal level, there are some essential benefits that each plan offers. These essential
- Walk-in patient services
- Emergency services
- Maternity care and newborn care
- Mental health services
- Drug coverage
- Rehabilitative services and devices
- Laboratory tests and services
- Preventive and wellness services as
- Management of chronic diseases
- Speech therapy
- Screening and Vaccines
- Pediatric medical services
ACA for Patients with Pre-existing Conditions
One of the biggest reforms of ACA is elimination of a pre-existing condition from national
healthcare program. This means that insurance providers are now barred from denying coverage or
increasing rates on the basis of an existing health condition.
Affordable Care Act can yield more value for individuals and businesses investing in plan. However,
there are a lot of aspects that must be weighed against your specific needs and requirements. The
Jordan Insurance Agency will help you understand these aspects and make a decision that is most
suitable for you.
Contact us now and share your questions and concerns regarding ACA with our consultants.