Health Care Reform Changes

  1. Extending Coverage for Young Adults: Young adults can stay on a parent’s plan until they turn 26. This doesn’t apply to young adults who already have health insurance through a job.
  2. Providing Free Preventive Care: New plans must offer free preventive services, such as mammograms and colonoscopies. This means they cannot charge you a deductible, co-pay, or coinsurance. (Note: This only includes new plans, not those already in effect when the health care reform law passed.)
  3. Banning Insurance Companies from Rescinding Coverage: When someone with health insurance got sick, insurance companies would sometimes search for an error or other mistake on that person’s application to deny coverage. That practice will no longer be legal. (Note: For most people, this will take effect in January 2011, at the beginning of a health plan’s new year.)
  4. Appealing Insurance Company Decisions: Consumers will have two ways to appeal coverage decisions or claims: through their insurer or through an independent decision-maker. (Note: This only includes new plans, not those already in effect when the health care reform law passed.)
  5. Eliminating Lifetime Limits on Insurance Coverage: Insurance companies can’t set lifetime limits on key benefits, such as hospital stays. (Note: This only includes new plans, not those already in effect when the health care reform law passed.)
  6. Regulating Annual Limits on Insurance Coverage: The law will restrict insurance companies’ ability to set annual dollar limits on coverage for individual and group plans.
  7. Guaranteed coverage for children with pre-existing conditions: Insurance companies cannot deny coverage to children under the age of 19 because of a pre-existing condition.
  8. See your OB-GYN without a referral: A woman will no longer need a referral to make an appointment with her OB-GYN. (Note: This only includes new plans, not those already in effect when the law passed.)
  9. Easier access to ER services: Insurers cannot charge higher fees when patients get emergency services out of their network. (Note: This only includes new plans, not those already in effect when the law passed.)

SOURCES:

Healthcare.gov.

Families USA Grandfathered Plans under the Patient Protection and Affordable Care Act.

Reviewed by Laura J. Martin, MD on September 08, 2010
This entry was posted in Health Care Reform. Bookmark the permalink.

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