Your Health, Your Choices
Lighthouse will help you understand what health care reform means for you and your family. Whether your young or aging, married with children or flying solo. There are lots of changes that will affect your health insurance now. The good news: You can access affordable health insurance, and we’re here to guide you to those solutions at no cost at all.
Access affordable insurance.
Count on Lighthouse to link you to health insurance plans that meet your budget and benefits needs. Call us for a free quote and educational tools. 866-230-0222
Health Reform & The Younger Set
Children and young adults gain unprecedented access to health insurance benefits, thanks to health care reform. New requirements took effect immediately after the law was passed in 2010. Here’s what you need to know:
CHIP for children. Children’s Health Insurance Program (CHIP) is administered by each state, and programs are jointly funded by the federal government and states. This program provides free or low-cost health coverage for more than 7 million children and teens. Changes or cuts to CHIP cannot be made until 2019. A child qualifies for CHIP if he or she is:
- 19 years or younger
- has no other available health coverage
- is a U.S. citizen, U.S. National or Qualified Alien
- Coverage without question. The Affordable Care Act (ACA) prohibits insurance companies from denying or delaying health coverage to any person under the age of 19. That includes children with pre-existing conditions.
- Riding on parents’ plans. Young adults now can stay on a parent’s health insurance plan until they turn 26. Adult children can join or remain on their parents’ plans even if they are: married, not living at home or with family, attending school full-time, not financially dependent on their parents, or eligible to enroll in their employer’s plan.
Help for High-Risk Individuals
Effective January 2014, health care provisions are in place to provide health care coverage to those with pre-existing conditions. Prior to 2014, the Affordable Care Act (ACA) set up temporary high-risk insurance pools.
Find out how to access affordable health care no matter your age, gender or health status. A Lighthouse health insurance specialist is standing by to answer your questions and help you find a solution. Oh, and it won’t cost you a thing. 1-(866)-230 - 0222
Purchase Insurance, Or Face a Penalty
That’s a simple way of explaining a complex and controversial issue, the Individual Mandate. Effective in 2014, the Affordable Care Act (ACA) requires most Americans without employee-sponsored coverage to purchase their own health insurance policies.
The cost of noncompliance: a penalty that gradually increases over time.
2014: The penalty is $95 per adult and $47.50 per child under 18 (up to $285 per family), or 1 percent of family income, whichever is greater.
2015: The cost increases to $325 per adult and $162.50 per child under 18 (up to $975 for a family) or 2 percent of family income, whichever is greater.
In 2016 and beyond: The fine climbs to $695 per adult and $347.50 per child under 18 (up to $2,085 per family) or 2.5 percent of family income, whichever is greater.
Exceptions to The Rule. Not everyone is required to purchase health insurance, or faced with a penalty fine.
- Americans with incomes below the federal poverty line do not have to pay taxes or purchase health insurance.
- Those who are “conscientiously opposed” to accepting benefits from public or private insurance because of religious beliefs (a sect in existence since 1950) are exempt. This includes, for example, Amish people.
- Members of Health Care Sharing Ministries (HCSMs), which are nonprofit organizations where members are the same faith and lifestyles, do not have to purchase health insurance or pay fines for not doing so. HCSMs act as clearinghouses for members who have medical expenses and those who wish to share the cost burden.
- Those who experience a single gap in insurance of less than 3 months are not subject to the tax penalty.
Health Coverage, Guaranteed
Regardless of health status, a person is eligible for health insurance coverage. This is called “guaranteed issue” and as of 2014, all new policies in the individual health insurance marketplace follow this requirement.
- Guaranteed vs. PICP? How does this eligibility differ from a pre-existing condition insurance plan (PICP)? PICPs are designed for individuals who have been denied coverage and who have not had health insurance for at least six months. Guaranteed issue laws are all-encompassing. Health insurance companies must issue coverage to any applicant, including those with pre-existing medical conditions.
- An exception to the rule. Grandfathered plans are exempt from most of the Affordable Care Act’s regulations, including the requirement to guarantee coverage to all individuals.
- Learn more. We’ll help you navigate your insurance options and find an affordable solution with the benefits you need. It cost nothing to get a free quote and get guidance from a Lighthouse insurance expert. Just call 1-(866)-230 - 0222.
Preventive Care, No Exceptions
Preventive care ultimately helps decrease the cost of health care. The healthier we are, the less we require emergency medical attention or care for serious diseases. The Affordable Care Act (ACA) encourages preventive care by ensuring the people with health insurance can get those annual physicals and well-checks at no extra cost.
- For adults.Preventive care includes blood pressure screening, cholesterol screening (for high-risk patients), HIV screening, immunization vaccines, sexually transmitted infection prevention, tobacco use screening and cessation intervention, preventive care services for women, anemia screening for pregnant women, mammography, HPV DNA testing, osteoporosis screening and more.
- For children. Some preventive care services included for children are autism screening for children 18 to 24 months, cervical dysplasia screening for sexually active females, hearing screening for newborns, height, weight and BMI measurements, lead screening, obesity screening and counseling, and more.
- Learn more. Visit healthcare.gov for a complete list, or call Lighthouse to find out how to access affordable health insurance and completely covered preventive care. Our service is free—there’s no catch.