The health care debate was a long and tedious one, but like it or not, many items in the new Health Care Reform Bill will take place between now and 2015. Surprisingly, most Americans are completely unaware that September 23, 2010, was the day several health care items went into effect.
Here are 5 health care law changes that will affect you today, and 3 health care law changes impacting your relationship with your insurance company:
Consumers can now:
1. Receive cost-free preventative services.
“New” plans must cover preventative treatments such as costly vaccinations, colon-cancer screenings, diabetes tests, cholesterol tests, and flu shots. For more detailed explanations of what qualifies as preventative services, go to www.healthcare.gov. (Note: when they refer to “new plan” they mean a plan you sign up for after Sept 22nd. Existing plans are exempt, but there are new limits on how much your costs can rise from now on.)
2. Add or keep your children on your health insurance policy until they turn 26 years old.
Who knew the Feds would make it easier to “mooch” off your parents? Children can live away from their parents, even be married (as long as you are under 26) and still be on your parents health plan. But the child is not covered if their employer offers a health insurance plan that they would be covered under. There are a couple details with how to enroll, you can get those answers at www.healthcare.gov.
3. Access out-of-network emergency room services.
In the past, some health plans would limit payment for emergency room services provided outside of a plan’s pre-selected network of emergency health care providers, or they would require that you get your plan’s prior approval for emergency care at hospitals outside of its networks. This could mean financial hardship if you get sick or injured while away from home. The new rules prevent health plans from requiring higher copayments or co-insurance) for out-of-network emergency room services. The new rules also prohibit health plans from requiring you to get prior approval before seeking emergency room services from a provider or hospital outside your plan’s network.
4. Choose the primary care doctor or pediatrician you want from your health plan’s provider network.
5. See an OB-GYN doctor without needing a referral from another doctor.
Insurance Companies Can No Longer:
1. Deny Coverage to Kids With Pre-Existing Conditions.
This condition only applies for children under 19, AND doesn’t apply to individuals who may have been “grandfathered” into. A grandfathered individual health insurance policy is a policy that you bought for yourself or your family (and is not a job-related health plan) on or before March 23, 2010 (the date that the new law was passed).
2. Place a “lifetime” dollar limit on most benefits you receive.
The act also restricts and phases out the “annual” dollar limits a health plan can place on most of your benefits — and does away with these limits entirely in 2014. Previously, insurance companies could put annual and/or lifetime limits of how much money could be spent on you in a particular year. This is no longer the case.
3. Refuse to evaluate any claim appeals the insurance company may have denied payment on previously.
If the insurance company reviews your claim and denies a second time, you have the right to have your claim reviewed by an independent reviewer who does not work for the insurance company. Again, go to www.healthcare.gov to better understand this provision.