CommuniCare Health Centers

I think the most common is that people will be penalized everywhere with this new law, when that is simply not the case. All you need to do is make sure you're covered with a comprehensive health plan, and you can do that through the marketplace at www.healthcare.gov or outside of the marketplace by pursuing a health plan of your choice. The only thing is that when insurance is bought through the marketplace, you might be eligible for assistance for your health insurance costs depending on your income and family size. The rates online do not reflect these cost savings. If you already have insurance, you do not need to do anything at all. Certified application counselors at CommuniCare are available for any questions and assistance to apply and enroll in health care coverage.

Who is eligible to purchase insurance in the new health care exchanges?

To be eligible for coverage, you must be a U.S. citizen or [a permanent resident or holder of a visa]. Some people who fall into that category will be exempt because health care coverage will still be deemed too expensive for them, meaning they fall below tax filing threshold, or Medicaid might be an option; they just have to apply.

When do the new insurance policies take effect?

Anyone who enrolls into a health plan and pays their first monthly premium for insurance through the marketplace by Dec. 15 will start receiving benefits on Jan. 1, 2014. All others after that date will start receiving coverage on the first of the current month when they pay their first premium by the 15th of the previous month. For example, if I pay my premium on Jan. 14, I will receive benefits on Feb. 1. If I pay on Jan. 16, I will receive benefits on March 1.

Aside from the mandate that everyone needs to be covered or face a penalty, what is the greatest difference between these new exchanges and the old method of getting coverage?

This method is a much simpler way of viewing your plans and any assistance paying for those plans you are eligible for. It lays them out for side-by-side, plain English, apples-to-apples comparison as if you were looking to purchase a trip through a travel website.

What would you say is the best first step for someone interested in learning more about the new health care laws and how they might apply to them?

The first step is to either give us a call at 210-233-7157 or log on to www.healthcare.gov for more information and assistance.

What do the new insurance plans cover?

The new plans cover ambulatory patient services (outpatient care); emergency services; hospitalization (such as surgery); maternity and newborn care; and mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services, and chronic disease management and pediatric services.

What is the next phase of the rollout of the Affordable Care Act?

I think the next phase people should look out for is the SHOP marketplace, which begins in 2014 for small businesses' health care coverage. We as certified application counselors are not trained in providing assistance for the SHOP marketplace, but navigators such as those at the Alamo Area Council of Governments can provide assistance.