How does the Affordable Care Act Benefit the Insured?

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Like your insurance? It’s your choice to keep it. Reform will only make it better because it creates consumer protections, such as banning insurance companies from setting limits on your coverage or dropping you if you get sick.

  • Protection for everybody against worst insurance company practices
  • Insurers prohibited from dropping people from coverage when they get sick
  • Insurers prohibited from denying coverage to children with pre-existing conditions
  • No more over-charging — insurance companies are required to report and justify their premium rates, and any requests to increase premiums
  • Increased transparency: health insurance companies must report proportion of premiums spent on patient care versus administration, profits, and marketing
  • All newly sold insurance plans will be required to cover prevention and wellness benefits with no deductibles or cost-sharing
  • Parents have the choice of keeping their young adult children (up to age 26, single or married) on their plan, so long as child doesn’t have option to get insurance through his or her workplace. The adult child no longer needs to be in college to be kept on the policy.
  • You will receive a rebate from your insurance company if more than 15% (large group market) or 20% (individual and small group market) of your premium dollars are spent on administration, marketing and profits instead of patient care
  • Limit the amount of contributions to a flexible spending account for medical expenses to $2,500 per year and increased annually by cost-of-living adjustment
  • Annual and lifetime benefit caps prohibited for all plans
  • Tax credits available for premium assistance to South Carolinians: who purchase health insurance on their own and earn up to 400% of the federal poverty level (98,400 for a family of four) or whose premium share of employer sponsored coverage exceeds 9.5% of your income
  • Caps on out-of-pocket expenses for insurance purchased through the Exchange helps protect South Carolinians from medical debt
  • Health care policies are written in clear and simple language so that benefits and care-providers are clearly defined
  • Premiums will no longer be based on health status (no more denying for pre-existing conditions)

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