WNYT.com

Answering questions about the Affordable Care Act

Posted at: 09/27/2013 3:18 PM
Updated at: 09/27/2013 4:42 PM



Many have questions about the Affordable Care Act. Especially, what if the Feds aren't ready by October first?

Robert Hinckley, the Chief Strategy Officer for Capital District Physician's Health Plan says New York is moving full speed ahead and New York's plan will be launched on October first.

New York took the lead and set up it's own healthcare exchange, or market place.

While delays by the Feds could affect New York's ability to verify income and immigration status, the insurance plans are ready for you to review.

There are four insurance tiers from bronze, the cheapest premiums but highest deductibles to platinum, most expensive premiums but least out of pocket cost.From individuals to small businesses employing 50 or fewer workers affected by the Affordable Care Act, Hinckley says before you buy, look behind the curtain as he puts it. It's not just about the cost but what that money's buying you.

Look at the network. A lot of the plans that are new to the market and some that have been in the market are using what's called a limited network. So certain doctors, and certain hospitals could be cut out of that.

All the plans under the ACA include what's called essential health benefits; emergency care, annual physical, mammograms, diagnostic colonoscopy and prescription drugs.

For the most part the coverage is going to be fairly similar from one plan to another. You could have some plans put more drugs available. You also could have plans limit the amount of pharmacies you could go to.

New York is among the states that expanded Medicaid eligibility to people earning up to 138 percent of the federal poverty level.

Plus incentives to help pay for health insurance are available to those earning up to four hundred percent of the poverty level.