The following video interview with Sarah O’Learly, CEO of Exhale Health Care Advocates, covers some Affordable Care Act Facts you may not know. Facts that could benefit you and your bank account.
Facts You Need to Know to Enroll in the Affordable Care Act (ACA or Obamacare)
ExHaleHealth.com’s CEO Sarah O’Leary gives insights into the Affordable Care Act and what people can expect when they enroll.
Frank Buckley, KTLA News Anchor: Today the answers to some of the major questions about the tomorrow’s open enrollment. Joining us is Sarah O’Leary CEO and founder of Exhale Healthcare Advocates it’s a nationwide service based in Marina del Rey that helps companies and individuals navigate the healthcare system.
Boy do we need you today but the I mean this it is upon us it seemed to sneak up on us and it is here for small businesses. l what is it and who is eligible
Sarah O’Leary: alright and thanks for having me we’re so excited is upon us because Exhale represents people, not companies not insurers not the government. We work for people and for individuals in small businesses who, as have tomorrow, can log onto CoveredCA.com they’re going to be able to have a way to transparently compare different platforms by insurance by insurer and see this is how much it’s going to cost and this is how it works and these are the benefits.
This will provide consumers an apples to apples comparison. There will be no caveat for pre-existing conditions. When you’re individually insured before they [insurance companies] might say, okay, you’ve got acne and that means that cannot ensure you. Acne was really that was one of the pre-existing conditions, while the insurers could pick.
So now there no pre-existing conditions, there are essential benefits and people can log on
or they can call the number. By the way we do not work for the government, we just believe that people should have affordable access to healthcare.
There are these great essential benefits. We had one client who was paying $1100 a month for her family’s coverage and they have a private practice and now they’re gonna pay $330 dollars less per month, just because the transparency in the competition in the marketplace. This is for better coverage and best of all, they can’t get kicked out if they get sick.
For small businesses we’re very optimistic it’s going to be great for them also. For individuals who have individual insurance and people who are uninsured were coming into the marketplace, they are great deals for premiums reduction where they get tax credits and they can save if they get sick. If they need to use
the system they can get supplemental money for that.
Altogether we’re cautiously optimistic. it’s a great step forward talking about the state California. It will it be different for different states, but speaking the state of California it’s called Covered California.
Jessica Holmes, KTLA News Anchor: In your opinion is this a good site for users?
Sarah O’Leary: Yes, CoveredCA.com, and I have to say and i can say the subjectively because we work across the country, it’s been regarded as one of the the gold standards for state systems. There are some states that have “sat the dance out” so in those states you use the federal government a site which is is also good.
While I believe they’ve done that they’ve done well, it’s a very user-friendly site but if you don’t understand it they do have people that you can call and talk to we provide the service. We don’t sell insurance but license navigators do. Licensed insurance agents can help you so there a lot of ways to work through it.
When you get to the site, you have got to know your policy, what what are the things that you through it that we need to look.
Frank Buckley, KTLA News Anchor: There is something called metal plan coverage. Walk us through these metal plans cover.
Sarah O’Leary: There are four health insurance coverage tiers including:
Essentially the way look at this is if you want to limit your fiscal risk and you can afford it, you chose the Platinum plan. With the Platinum plan, you are going to pay more in a monthly premium, but the benefits you receive will be better.
The coverage plans go down so bronze, which typically has a 60/40 coverage split in terms of what costs are covered and what costs are paid for by the patient.
Platinum coverages is more typically a 90/10 coverage split. A lot of people are saying well I’m just going to get the bronze coverage. we’ve got entrepreneurs we represent people who own startup small businesses on just gonna get the bronze plan.
I said well you know if you want to go gamble, go to Vegas. But if you have enough money to get a higher plan, look at what your family needs. Study the plan options to make sure your doctors and your hospitals are in the plan and then make a decision. The key is to make a smart and informed decision.
Jessica Holmes, KTLA News Anchor: We know this is a big deal for people for sure uninsured.For people who are inured, they can make sure they have the best health insurance, Can a shop for better rates through this system? Is that possible?
Sarah O’Leary: Yes and that is really a great question because a lot of people haven’t realized
that. This isn’t some sort of simple extension of a Medical. This is actually for anybody who has individual or small business insurance. There are lot of us out there. Many people have their health insurance through a group health plan. This is typical if they’re working for a big employer. For everybody else, you can go on the exchange and save a great deal of money and change your health insurance during open enrollment.
We encourage people to check it out, to get on and get informed. Realize what you’re specific needs are and then sign up.
If you have any questions call the their numbers or call groups like us or call other facilitators and and get signed in. Coverage you select will become effective in January of next year.
Frank Buckley, KTLA News Anchor: We appreciate it. We should just tell our viewers this is to this is not a comment on the politics of Obamacare Affordable Care Act at all. This is real information on the legislation passed along time ago. This legislation is going into effect now so we’re trying to help you with some real information.
We are going to be providing healthcare coverage information all week long. Here’s some information right now on Exhale Healthcare advocates. We’re going to have the information for at KTLA.com in our viewer information area.
Obama care enrollment begins tomorrow. Covered California is an online healthcare marketplace by the state of California.
Join us on Wednesday the day after enrollment to a follow up on the the most asked questions at that time, the problems and solutions. Tomorrow, Doctor John the all will continue our series on Obamacare with his insight about doctors, hospitals and the Affordable Care Act.
Thanks for coming.
Sarah O’Leary: Thank you thank you so much for having me.