The Daily Item, Sunbury, PA

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September 25, 2013

"Is my spouse covered?" and other questions about the new health-care law


Q: How will I know if I receive the best deal?

A: One of the ideas behind the exchange is that consumers will be able to see all the plans offered, as well as the premiums they would pay for the coverage, in one place. So you will be able to compare across different insurers, which will be competing for your business. You'll have to decide what policy makes the most sense for you, based on such factors as premium cost, the annual deductible and any other cost-sharing, such as co-payments for doctor visits or hospital care. Another factor some consumers look at is whether their doctor or hospital is included in the insurer's network.

Q: My son has undergone treatment for cancer under my employer's medical insurance program, but it runs out next year, when he turns 26. He is unemployed and will have no other insurance. What are his options, and will his pre-existing medical problems make it difficult to obtain insurance? Will he pay a higher premium?

A: One of the biggest changes under the health law is that it bars insurers from rejecting applicants with pre-existing medical conditions, starting Jan. 1. It also prevents insurers from charging people with health conditions more than those without.

Starting Oct. 1, your son can start looking at these new marketplaces we've been discussing here to see what plans are available in his area and compare prices. Depending on his income, he may also qualify for a subsidy to offset part of the cost of the coverage.

Q: Will there be dental insurance plans on the exchange?

A: Dental coverage is an "essential health benefit" for children only on the exchanges, not adults. For adults, dental coverage may be sold as part of a health plan or as stand-alone coverage. You'll have to look to see what's offered on the exchange where you purchase coverage.

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