Several major aspects of the Patient Protection and Affordable Care Act, or Health Care Reform, will take effect on September 23rd:
Extending Coverage for Young Adults
Under the new law, young adults will be allowed to stay on their parent’s plan until they turn 26 years old. (In the case of existing group health plans, this right does not apply if the young adult is offered insurance at work.) Some insurers began implementing this practice early. Check with your insurance company or employer to see if you qualify. Learn more about the young adults insurance policy.
Providing Free Preventative Care
All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance. Learn more about preventive care benefits.
Prohibiting Insurance Companies from Rescinding Coverage
In the past, insurance companies could search for an error, or other technical mistake, on a customer’s application and use this error to deny payment for services when he or she got sick. The new law makes this illegal. After media reports cited incidents of breast cancer patients losing coverage, insurance companies agreed to end this practice immediately.
Appealing Insurance Company Decisions
The law provides consumers with a way to appeal coverage determinations or claims to their insurance company, and establishes an external review process.
Eliminating Lifetime Limits on Insurance Coverage
Under the new law, insurance companies will be prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays.
Regulating Annual Limits on Insurance Coverage
Under the new law, insurance companies’ use of annual dollar limits on the amount of insurance coverage a patient may receive will be restricted for new plans in the individual market and all group plans. In 2014, the use of annual dollar limits on essential benefits like hospital stays will be banned for new plans in the individual market and all group plans.
Prohibiting Denying Coverage of Children Based on Pre-Existing Conditions
The new law includes new rules to prevent insurance companies from denying coverage to children under the age of 19 due to a pre-existing condition.
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