If You're Uninsured or Buying Your Own Insurance

If you are self-employed or working in a small business, buying insurance for yourself and your family—or have no insurance at all—you are among those that the new law helps the most. Millions of Americans currently pay the highest rates for health coverage because they buy it on their own. Others—especially those ages 50 to 64—can’t buy coverage at any price because they have preexisting medical conditions. Making private insurance more accessible and fairer for consumers is a central goal of the new law.

Immediate help: If you have a preexisting condition and have been uninsured at least six months, you’ll be eligible to buy coverage through a temporary high-risk program—which limits what you’ll be charged for out-of-pocket costs—that starts in July and ends when insurance exchanges become available in 2014.

Immediate coverage protections: Insurers can no longer drop your coverage if you’ve paid your premiums. Health plans can’t limit what they will spend on your care during your lifetime. Starting in 2014, they can’t place limits on your annual health costs either. Plans must justify steep price hikes.

Preexisting conditions: Starting in September, children cannot be denied coverage because of a preexisting condition. Adults receive the same protection in 2014.

Coverage for adult children: If your company offers a family coverage plan, unmarried children can be covered under your policy until they reach age 26. This change begins in the fall, but you should consult your insurer to find out which month it takes effect for your plan.

Health plan choices: Starting in 2014, you can select a private health plan from a menu of choices offered through an insurance exchange run by your state. And your yearly out-of-pocket expenses will be limited.

Enrollment and premium protections: Health plans cannot deny you coverage or make you pay more for your insurance because of your health, past medical problems or gender, starting in 2014. But they can raise premiums by up to 50 percent for people who smoke.

Free preventive care: Health plans you buy on your own must cover certain preventive services, screenings and vaccinations free of charge. This requirement starts as soon as your current plan’s next coverage year begins or when you join a new plan.

Age rating: Starting in 2014, insurers can charge older people no more than three times the amount they charge younger adults. Currently, insurers can charge older people up to 10 times what they charge younger people.

Other Insurance Situations

• If You Receive Employer Insurance
• If You Run a Small Business or Work for One
• If You’re Uninsured or Buying Your Own Insurance
• If You Have a Moderate or Low Income
• Just Where Are Those Savings Coming From?

More Insights About the New Health Care Law

• Five Things in the Law That May Surprise You
• Will My Taxes Go Up?
• Who Must Have Insurance?
• Coverage as Good as Congress’?
• How Will the New Law Affect My Doctors?