. Affordable Care Act FAQ - New Orleans Musicians' Clinic

Affordable Care Act FAQ

Know Your Options – Frequently Asked Questions and Facts about the Affordable Care Act (ACA)

 

Upcoming ACA Enrollment: November 1,2016 – January 1,2017

 

Under the 2014 Health Care Law every USA Citizen is required to have health insurance. Visit HEALTHCARE.GOV for more information on plans and enrollment.

Visit our ACA Resources webpage to learn more about the Affordable Care Act


Frequently Asked Questions


Will I still be able to use the NOMC?

Yes. In fact, under ACA, the NOMC will receive additional funding if you select us as your Medical Home.

The New Orleans’ Musicians Clinic encourages ALL our patients and those in our music community to please comply with the new health law to support Obamacare.

  1. Protect your health and your wallet! Your body is your most vital instrument! Under the new health insurance plan emergency room visits, hospitalizations, labs, RX, mental health treatment, diabetes and cholesterol screenings, prostate exams, mammograms are ALL covered.
  2. Keep the New Orleans Musicians Clinic ALIVE by letting us serve as your Patient Centered Medical Home and be paid for your care by ACA.
  3. Most of the new health insurance plans offered may cost less than your cell phone plan. Health insurance is just as vital to your career as your car and your cell phone.

Who can help me figure out what my best option is?

There are still many factors to work out but the NOMC is here to help.
Our Social Services coordinator can review best options with you.
Megan • 412-1366 • mmcstr@lsuhsc.edu

The NOMC&AF have just received a grant which will allow us to employ a fulltime community health worker to assist during this time of transition.


What are the benefits of getting a Health Insurance Plan?

  • The health care law requires many insurance plans to provide coverage without cost sharing to enrollees for a variety of preventive health services.
  • Insurers can not refuse coverage to anyone.
  • All new health insurance plans must offer an essential benefits package which limits your out of pocket expenses.
  • NO more annual $ limits on medical benefits the insurers will pay out for your care.
  • If you become ill or injured when you are outside of New Orleans, your medical care will be covered all over the USA.

What are the penalties for not having health insurance?

Penalties are pro-rated by the number of months you don’t have insurance beginning Jan. 1, 2014.

• 2014: Fine can be up to $285 for a family or 1% of family income, whichever is greater. ($95 per adult and $47.50 per child)

• 2015: Fine can be up to $975 for a family or 2% of family income whichever is greater. ($325 per adult and $162.50 per child)

• 2016 and Beyond: the Fine is up to $2,085 for a family or 2.5 % of family income whichever is greater. ($695 per adult and $347.50 per child)


When do I need to sign up?

 

The next Open Enrollment Period for 2017 is November 1, 2016 — January 31, 2017.

For more information please visit: https://www.healthcare.gov/quick-guide/dates-and-deadlines/

 


Can I still go to Charity/ Interim Louisiana Hospital/ Lord & Taylor clinics, if I don’t have health insurance?

Beware: If you do not qualify for Medicaid or “Free Care” and do not have health insurance, you will get billed for the services you receive at these providers.


Who is exempt from the new law?

If your family income is below the threshold for filing a USA Tax return:

$11,490 for an individual
$23,550 for a family of 4

If you currently have a combination of any of the following health coverage:

Medicare • Medicaid
TRICARE (armed service, retirees and their families) • VA
Private insurance or employee provided insurance


Who are the 5 companies who have applied to offer health insurance plans in Louisiana beginning October 1, 2013?

  1. Blue Cross/Blue Shield of Louisiana
  2. Coventry
  3. Humana
  4. Louisiana Health Cooperative (a non- profit formed by the Ochsner Health System. It is headed by Republican state Representative Cromer, chair of the La. House Insurance Committee)
  5. Vantage

How much will health insurance cost me?

You can get a rough estimate from this easy to use calculator.
http://www.kff.org/interactive/subsidy-calculator/


Are there special insurance plans for people under 30?

Adults under the age of 30 may enroll in lower-cost, high-deductible “catastrophic plans” which offer prevention benefit, 3 annual primary care visits and will be exempt from a deductible.

Adult children under the age of 26 can enroll in their parent’s coverage.


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