Health Care Reform
The Affordable Care Act was designed to improve quality and lower costs of health care; provide consumer protections, mainly in regard to insurance coverage; and increase access to care, especially among lower income, uninsured, and underinsured populations.
Highlights of the law include:
- Guaranteed coverage regardless of pre-existing conditions
- No annual or lifetime dollar limits on coverage benefits
- Capped annual out-of-pocket expenses
- No dropped coverage due to illness, simple errors in application, or participation in clinical trials
- Equitable premiums, regardless of gender or pre-existing conditions
- Coverage for young adults, up to age 26, on parent’s policy
- Preventative care coverage, including full cost of some screenings, tests, and vaccines
- Essential health benefit coverage, to include coverage for
- Ambulatory patient services
- Emergency services
- 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 and chronic disease management
- Pediatric services, including oral and vision care
- Concurrent hospice and curative care options for parents of children with special health care needs.
Marketplaces have been created for the purchase of health insurance. Indiana uses the federal marketplace. Individuals and families may access the marketplace to compare and purchase insurance policies. Streamlined, simplified applications, which screen for Medicaid and CHIP eligibility, are available on the marketplace. To apply cost-sharing and premium tax credits based on family income and size, policies must be purchased from the marketplace.