On Tuesday, Oct. 1, the Maine health insurance Marketplace (Exchange) of ObamaCare opened. Despite the brouhaha, there are many people who have already benefited from parts of the law without their realizing it.

The law, The Patient Protection and Affordable Care Act, signed in March 2010, immediately began to change the rules for health insurance providers. Health insurance plans began accepting children with pre-existing conditions and young adults under 26 on their parent’s health insurance plan; were prohibited from placing lifetime limits on coverage and arbitrarily canceling coverage; began to cover certain preventive health services with no co-pays or deductibles, such as colonoscopy screening, Pap smears, mammograms, and flu shots; small business tax credit kicked in for businesses who provided health insurance for their employees and, lastly, adults who were previously denied health insurance coverage because of pre-existing conditions began to receive temporary coverage via an affordable high-risk pool.

In 2011, because of ObamaCare, prescription drug discounts for seniors were introduced, the “donut hole” began to close and Medicare preventive services for seniors were provided without a co-pay. The “80/20 Rule” required insurers to use at least 80 cents out of every premium dollar to pay for medical claims, instead of overhead costs and profits. Finally, insurance companies were forced to publicly justify any rate increase of 10 percent or more before raising premiums.

In 2012, most plans began to cover additional preventive health services for women, such as breast cancer screenings. The donut hole for seniors’ prescription drug costs continued to close. Consumers were provided easy-to-understand summaries about a health plan’s benefits and coverage.

While the six-month period (Oct. 1, 2013 to March 31, 2014) is the time frame for enrolling in a health insurance plan offered in Maine’s Marketplace, most Mainers will not be affected because they already have health insurance. Mainers who have health insurance through their employer and those covered by public insurance – Medicaid, Medicare, and military and veterans’ coverage – won’t be shopping for insurance in the Marketplace.

Although ObamaCare requires that Americans obtain health insurance (whether private or public), there are exceptions if:

•You are very poor (under 100 percent of the federal poverty level) and live in a state that didn’t expand Medicaid (like Maine).

• Your religion prevents you from accepting insurance benefits.

• You are part of a health care sharing ministry.

• You are a member of a federally recognized Indian tribe.

• You lack insurance for less than three months in a row.

• You have suffered a certified hardship.

• You cannot afford coverage because you would have to pay more than 8 percent of your household income for coverage.

• You are behind bars.

• You are neither a U.S. citizen, nor a U.S. national.

• You are an undocumented immigrant.

In fact, the Maine Bureau of Insurance has estimated that 5-8 percent of Maine residents, (65,000 to 104,000 people) will sign up for insurance in the 2014 Maine Marketplace.

In the Marketplace, Mainers will find a wide range of options and prices based on income, age, county of residence, subsidies and family size. Subsidies in the form of tax credits are available for those between 100 percent and 400 percent of the federal poverty level. Additional reductions in the cost of co-pays are available for those earning between 100 percent and 250 percent of the federal poverty level. Insurance plans range from a Bronze level to a Platinum level. Obviously, the Bronze-level plans reflect the lowest cost of monthly premiums but also reflect higher co-pays for office visits, hospitalization and prescriptions and a higher out-of-pocket deductible before the plan actually kicks in.

The Silver plans may be the most popular because they may be the most comprehensive plans at the most affordable price. Whether you chose a bronze, silver, gold or platinum plan, annual out-of-pocket medical and drug co-payments and deductibles are capped yearly at $6,350 for an individual and $12,700 for a family. This calculation does not include monthly premiums. The reality is that some people experiencing a major health event, such as a heart attack or an accident, will reach this out-of-pocket cap in a day.

Remember, if you do not qualify for subsidies in the form of tax credits or other cost reductions, you may choose to purchase insurance outside of the Marketplace. However, all plans, whether in the Marketplace or not, offer the same “essential benefits” and the same annual out-of-pocket cap noted above.

Finally, ObamaCare mandates that all health insurance plans offer a set of “essential health benefits,” including outpatient care, prescription drugs, emergency care, mental health services, hospitalization, rehabilitative services, preventive and wellness services, laboratory services, pediatric care (including dental and eye care) as well as maternity and newborn care

For more information, visit www.enroll207.org or www.healthcare.gov.

Maurie Hill is a resident of Standish and health-care professional.