- High-risk pools: The health reform law creates a temporary high-risk pool that provides immediate access to insurance for any South Carolinian with a pre-existing condition who has been uninsured for least 6 months. The new high-risk pool begins in July.
- South Carolina is not running its own high rist pool. If you have been uninsured for the past six months you can enroll through www.healthcare.gov
- Increased funding for Community Health Centers (CHC), which provide free or low-cost, sliding-fee scale services. Increasing the number of the CHC’s means increase in access and affordability of care, especially in rural areas.
- Adult children (up to age 26) will be able to stay on parents insurance, with parents permission and provided that they don’t have access to employer sponsored coverage
- Children with pre-existing conditions can no longer be denied coverage by insurers
- Uninsured patients protected by new nonprofit hospital standards:
o Written financial assistance policies clearly stating eligibility guidelines & how to apply
o Protections from being overcharged
o Prohibits extraordinary collection actions against patients
- Adults with pre-existing conditions can no longer be denied affordable insurance
- Individuals buy insurance through a new online, state-based marketplace called an exchange
- Individuals and families may receive subsidies to help buy coverage from the health insurance exchange. Based on your income, there will be a cap to the amount you will be charged for premiums and your out-of-pocket expenses will also be capped
- Medicaid will expand to all adults and children with incomes up to 133 percent of the poverty level
- Those who cannot afford to buy insurance may apply for a hardship waiver; subsidies will be available to Tennesseans with incomes of up to 400 percent of the poverty level
- If you can afford coverage and choose not to buy it, you will be fined an amount that escalates each year, up to a maximum of $2,085 or 2.5% of household income in 2016
- Caps on annual benefits are banned