Will health insurance cost more in 2014?
June 26, 2013
The answer is not easy to give. For some people costs may go up, at least in the short-term. For others costs may go down or stay the same.
What is critical to understand is that the Affordable Care Act – Health Care Reform – sets a new minimum benefit standard for every major medical health insurance policy in the country.
Beginning in January 2014, any major medical plan sold must provide coverage for a minimum of 10 essential health benefits, including:
- Ambulatory patient services;
- Emergency services;
- Maternity and newborn care;
- Mental health and substance abuse
- Prescription drugs;
- Rehabilitative and habilitative services;
- Laboratory services;
- Preventive and wellness services and chronic disease management;
- And pediatric care.
And, the law requires that all of these benefits must be covered at a minimum of 60% of their actuarial value.
You’re probably wondering, What is actuarial value?
The easiest way to explain it is to say that it is a percentage of total average costs for covered benefits that a plan will cover.
So, a plan with 70% actuarial value would typically cover 70% of the costs and the customer would typically be responsible for 30% of the costs.