Health Care Reform

Health Care Reform is bringing changes to Maine’s health care system in the coming months. By the end of the year, there will be new requirements for individuals and employers, new options for affordable health coverage for many Mainers, and many new rights, protections, and changes to current government health care programs. Here are a few things you should know about what’s new and what’s coming soon.

A New Health Insurance Marketplace
Starting in October 2013, there will be a new way to get health insurance: the Health Insurance Marketplace

The Marketplace is designed to help you find health insurance that fits your needs and your budget —in plain language that makes sense. You will be able to shop online or through a toll-free phone line. You will also be able to get free in-person help with applying and understanding your options from a certified Health Navigator.

• Every health insurance plan in the Marketplace will offer broad coverage, including visits to your doctor, the hospital, and medications.

• Most people will be able to get a break on costs through the Marketplace. The Kaiser Family Foundation has an online cost calculator you can use to see what you might pay through the Marketplace.

  • Marketplace enrollment starts in October 2013. Check out healthcare.gov for more information.

    Don’t Get Scammed!

    Health Insurance Marketplace enrollment doesn’t begin until October 1, 2013. If someone calls to sign you up for insurance through the Affordable Care Act before then, they are trying to scam you. If you get one of these calls report it to the Federal Trade Commission.

    New Consumer Protections

    Because of Health Reform, people now have the right to appeal their health plan’s decisions. If you think your plan has incorrectly denied a claim or coverage, you can get help from Consumers for Affordable Health Care to file an appeal.

    • Starting in 2014, no one can be denied coverage based on a pre-existing condition.

    • No matter what kind of health insurance you have, you can now get many preventive services, like certain screenings, vaccinations and counseling, with no co-pay or deductible.

  • Young Adults

  • Young adults (under age 26) may now be able to join or stay on their parents’ health insurance plan, even if they are married, have jobs, move away from home, or are financially independent.

    People with Medicare

  • People with Original Medicare have no out-of-pocket costs for most preventive care, like annual wellness visits, flu vaccines, and screenings for diabetes, cancer and depression.

    • People with Medicare now have improved Part D prescription drug benefits (discounts on drugs if they fall into the coverage gap).
    • For more information on Medicare, check out your local Area Agency on Aging or visit Legal Services for the Elderly.

    Refugees, Asylees & Immigrants
    Refugees, asylees and legal permanent residents with a green card for more than 5 years, and legal immigrants who are under age 21 or pregnant may be able to get MaineCare.
    • Immigrants who are lawfully present may also be eligible to get health insurance through the Health Insurance Marketplace. Immigrants who are lawfully present include legal permanent residents with a green card, refugees and asylees.

    Have questions about Health Reform? Contact Jake Grindle, WMCA’s Health Services Navigator, at jgrindle@wmca.org, or 1-800-645-9636.

    For more information on Health Care Reform please contact Consumers for Affordable Health Care at www.mainecahc.org or 1-800-965-7476

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