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September, 2010 will bring another milestone to health care reform. In September, sweeping changes in health care reform include expansion coverage for young adults along with restrictions on an insurer's ability to impose annual coverage limits (or reject children with pre-existing medical conditions).
Beginning September 23, 2010, insurance coverage that begins on or after the 23rd will have to comply with changes that were put in place when President Barack Obama signed the health overhaul into law March 23.
For most people, the changes won't affect their plans until coverage renews in the weeks or months that follow. September highlights include:
• Insurers will be prohibited from rescinding or canceling coverage except in cases where the customer commits fraud.
• Insurers will not be able to exclude children from coverage because of a pre-existing condition but they can require parents to sign up kids only during a fixed annual enrollment period to ensure they don't wait until a child gets sick to buy coverage.
• Adult children up to age 26 will be able to receive dependent coverage with all individual and group policies.
• Lifetime limits on the dollar value of insurance coverage will be prohibited. This refers to how much your insurance coverage pays out to cover claims.
• Restrictions will be placed on annual limits for coverage, a practice that will prohibited in 2014.
• Insurers will be required to provide preventive care like immunizations or mammograms without charging co-pays or other forms of cost sharing. Some may not have to comply with this element if their coverage existed March 23 and has not changed substantially.
• Individual plans that have so-called "grandfathered status" will not have to immediately follow the new restrictions on annual coverage limits or eliminate their lifetime caps. Over time, most plans will lose their grandfathered status as they make changes in benefit designs.
The main focus of the health care reform provisions in September are consumer protections.
However, experts have cautioned that these restrictions and coverage expansions will raise the cost of insurance for some customers.
Enrollment has started in some states for temporary insurance which will cover people with pre-existing medical conditions and who have been uninsured for at least six months. Some small businesses that offer employee health coverage can seek tax credits that will apply for this year.
The law will continue to develop over the next several years. In 2011, insurers will be required to offer rebates if they don't spend a minimum percentage of their premiums on medical costs. Details are still being worked out.
Some of the biggest reform provisions start in 2014. In 2014, most citizens and legal residents will be required to have health care coverage and many will receive help from the government through income-based tax credits when they shop for coverage on health insurance exchanges. Also, Medicaid will be expanded to reach more people.
Sources:
Associated Press
MSNBC
MC Ortega is the former publicist for the late Walter Payton, Coca-Cola and Dunkin’ Donuts. Ortega is a senior communications and messaging executive specializing in media relations, social media, program development and crisis communications. Also, Ortega is an avid traveler and international shopper. Ortega resides with her partner, Craig, dog, Fionne and extensive shoe collection. Ortega also enjoys jewelry design/production and flamenco dancing.
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October 8, 2010 - 11:39amThis Comment