This past week was the six month anniversary of the signing of the Affordable Care Act by President Obama. Several important pieces of the health care reform bill went into effect on September 23, 2010. This post highlights the most important changes in federal health care law. In addition, it provides more information on www.healthcare.gov, a national website that has valuable information for everyone wanting more information.
In effect as of September 23, 2010:
Rescission is Outlawed
Insurance companies aren’t allowed to drop people’s coverage when they get sick (this is known as “rescission”).
New Coverage Options for Children
Insurance companies aren’t allowed to deny coverage to children under 19 because of pre-existing conditions.
Children can stay on (or be added to) their parents’ insurance policies until they turn 26, if they can’t get insurance through a job. This applies to all insurance plans that provide dependent coverage. A new open enrollment period for children starts on September 23, 2010 and is required by law to continue for at least 30 days.
Ban on Lifetime Coverage Limits
For new individual insurance and all group plans, insurance companies aren’t allowed to put caps on the amount they will spend on lifetime coverage costs on “essential benefits”. Essential benefits include hospital stays, doctor visits, and prescription drugs.
Annual limits are restricted in all group plans and in new individual plans. Starting in 2014, annual limits will be banned completely.
More Preventive Services Covered by Private Health Coverage
All new group and individual plans will have to cover certain recommended preventive services, like cancer and diabetes screenings. Insurance companies will be required to offer these services free to the patient - without deductible, coinsurance, or copayment charges.
In effect in 2011:
Prescription Drug Discounts for People who Fall in Medicare’s Donut Hole
Starting January 1, 2011, people on Medicare who fall within the prescription drug coverage gap (the “donut hole”) will get a 50% discount on brand name prescription drugs and a 7% discount on generics.
These discounts are in addition to the annual rebates for people who fall in Medicare’s “donut hole”.
The website www.HealthCare.gov can provide you with invaluable information on changes under the health reform bill, the Affordable Care Act of 2010 (ACA).
For beneficiaries, there is an easy-to-use tool on this website called “Find Insurance Options”. Beneficiaries can use this tool by themselves to learn about the health care options that are available to them, given their circumstances (age, health condition, etc.). For example, it will provide information on specific Medicaid categories that they may be qualified for. It can ba found at: http://finder.healthcare.gov/ .
To read about changes to the High Risk Pool program in you state, go to http://www.healthcare.gov/law/provisions/preexisting/index.html and enter in your state. You will learn about how your state has chosen to implement its Pre-Existing Condition Insurance Plan program, which can either supplement or replace the existing state High Risk Pool. There is also a timeline on the website showing major changes that occur each year, with links to more information on each change.
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