The new health care reform law, the Affordable Care Act, may be confusing. Many of the changes affecting insurance coverage won’t go into affect until 2014, but if you’re starting new coverage after Sept. 23, 2010, you will be able to take advantage of some changes sooner than others. Likewise, if you are a retiree, or a youngster, you can take advantage of improved coverage.
Here are some things you may want to know regarding health care reform:
1. I’ve heard a few parts of the law will become effective as of September 23, 2010. What changes are coming soon?
• Extending Coverage for Young Adults – young adults will be allowed to stay on their parent’s plan until they turn 26, unless their employer offers coverage.
• Providing Free Preventive Care – new plans must cover preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or co-insurance.
• Prohibiting Insurance Companies from Rescinding Coverage – makes it illegal for insurance companies to deny coverage if an error or technical mistake is “found” in the policy holder’s application after claims are received (i.e., getting sick).
• Appealing Insurance Company Decisions – new policies allow consumers to appeal coverage determinations or claims and will establish an external review process.
• Eliminating Lifetime Limits on Insurance Coverage – insurance companies will not be allowed to impose lifetime dollar limits on essential benefits like hospital stays.
• Regulating Annual Limits on Insurance Coverage – insurance companies no longer will be able to restrict essential benefits such as hospital stays based on annual dollar limits on new policies. In 2014, such restrictions will be banned for all policies in individual and group plans.
• Prohibiting Denying Coverage of Children Based on Pre-Existing Conditions – new rules prevent insurance companies from denying any child coverage under the age of 19 due to a pre-existing condition.
2. What is being done to keep my health insurance premiums from increasing?
• States requiring insurance companies to justify premium increases may be eligible for $250 million in new grants, and insurance companies with excessive or unjustified premium increases may not be able to participate in the new health insurance programs in 2014.
3. What is being done in regard to helping Americans lead healthier lifestyles?
This year, there is new investment of $15 billion in a Prevention and Public Health Fund designed to promote smoking cessation and combat obesity.
4. My community has very few options in quality affordable health care. What is being done this year to help?
• New incentives are being put into place to encourage and expand the number of primary care doctors, nurses and physician assistants. Incentives include tax-free scholarships, and loan repayments for those medical professionals working in underserved communities.
• Community health centers should be receiving a shot in the arm with new funding to support construction and expansion of services; it is expected to allow 20 million new patients access to health care.
• Rural areas also can help attract and retain qualified medical professionals with increased payment for those doctors, nurses and nurse practitioners working in remote areas of the United States.
Do you have a question about health care reform? Check out EmpowHER’s pages. Sign-up, post a question, share your story, connect with other women in our community and feel EmpowHERed!
Resources:
http://www.healthcare.gov/law/timeline/index.html Understanding the Affordable Care Act
www.hhs.gov Department of Health and Human Services
Christine Jeffries is a writer/editor for work and at heart, and lives in a home of testosterone with her husband and two sons. Christine is interested in women’s health and promoting strong women.