Americans can expect better out-of-pocket protections

A common misconception about health insurance is that if you are covered, you don't have to worry about skyrocketing health care costs. We pay insurance companies premiums every month so we won't have to shell out tons of money when we get sick, right? In theory that's true, but in practice it doesn't always work out that way.

According to a report by Families USA, nearly one in four Americans were in families that spent more than 10 percent of their pre-tax income on health care related expenses in 2009. And 18.7 million Americans were in families that spent more than 25 percent of their pre-tax income on health care. For middle-class families struggling to make ends meet, that is a significant chunk of change.

Left unchecked, rising premiums and out-of-pocket costs could leave more Americans in a tight bind-and in some cases could lead to bankruptcy.

Another report by Families USA shows that unaffordable cost-sharing leads people to delay treatment even when they're sick. This means that when they get so sick they must seek out treatment, it's inevitably more expensive.

Thanks to health reform, however, Americans can expect some relief. Thanks to health reform, the amount that anyone will have to pay out of pocket for health expenses each year will be capped -giving Americans peace of mind that they will be covered when they need it most.Additionally, lower- and moderate-income people will receive extra assistance with out-of-pocket costs and will have lower out-of-pocket caps.

For too long, many Americans have been blindsided with huge out-of-pocket costs when they thought they would be covered. But thanks to health reform, we'll be covered when we need it, and consumers' pockets will be a whole lot deeper.

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Comments

  1. Marva H. Carter's avatar

    Marva H. Carter

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    Does the out of pocket expense protection give any assistance or tax credit for hearing aids?
  2. DENISE HESS's avatar

    DENISE HESS

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    I would like to know how this aids consumers/customers with their requirements for supplement/alternative health items to Western medicines
  3. marie minichiello's avatar

    marie minichiello

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    I WOULD LIKE TO KNOW WHY MEDICARE ONLY PAYS FOR 30 DAYS IN A REHAB AND THEN YOU HAVE A COPAY.MY MOTHER IN LAW WAS SENT HOME FROM REHAB AND SHE IS WORSE OFF NOW THEN WHEN SHE WENT IN. SHE CANT WALK OR GET IN OR OUT OF BED. SO WHERE IS THE HELP FOR THE SENIORS. SHE IS 83. ALSO WHY DOESNT MEDICARE COVER HEARTING AIDES SHE IS DEAF IN BOTH EARS. SOMETHING NEEDS TO BE DONE TO PROTECT THE ELDERLY AND FAST !!!!!
  4. MaryJo Thomas's avatar

    MaryJo Thomas

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    I am self-employed (Independent contractor) who buys her own health insurance through one of the mega-companies (there really isn't much difference). In order to afford insurance, I had to agree to a $5000 (yes, that is three zeroes) deductible. When I turned 60, my premiums went up 27 percent. In the mail today, I rec'd my new policy effective April 1, 2011. My premiums are going up another $38. I am 61 years old.

    The Obama health care really doesn't protect me in any way, does it? These crooks can continue to raise my remiums as I age. Quite likely, before I am old enough for Medicare, I will not be able to afford may premiums.

    Please advise.
  5. Erin's avatar

    Erin

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    Hi MaryJo,

    The Affordable Care Act protects you in several ways. First, beginning in 2014, it limits how much more an older person can be charged to three times the rate a younger person is charged. Though this still may sound very high, it is much better than the current law in many states where there are often no limits. Secondly, states have received grants to review rates and make sure they are reasonable, and a number of states have passed laws that for the first time give them power to reject insurance companies' plans to raise rates if the premiums are not reasonable in relationship to the benefits provided. Third, in 2014, individuals will be able to shop in a new regulated marketplace called an "exchange". Individuals with incomes under about $43,560 in todays' dollars (and the amount is larger for families) will be able to get help paying their premiums.

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