A few healthcare laws changed immediately with the passage of the Healthcare Reform bill, but most will take some time to take effect. Several important measures that don’t affect your taxes go into effect on September 23, 2010. You may have already received a notice about them from your health insurance company. If not, here’s what you need to know:
Health Insurance for Adult Children
Under the old law, children were no longer eligible for their parents’ insurance once they graduated from college or reached age 24, whichever came first. Under the new law, the coverage is extended to age 26, unless the child’s employer offers insurance. If you have an adult child who hasn’t yet found employment, or became unemployed, contact your insurer to re-enroll your child in your policy. Some insurers chose to keep adult children on the policies in the gap between graduation and September, but some didn’t.
Free Preventative Care
Starting now, your insurance company may no longer apply a deductible, co-insurance, or co-pay to preventative screenings like mammograms and colonoscopies. Well-baby and well-child visits are also included in this category.
No Rescinded Coverage for Technical Errors on Applications
Part of what prompted this particular reform were the horror stories about women with breast cancer having their coverage canceled because they forgot to mention a mole they had removed fifteen years earlier or other such ridiculous claims. Health insurance companies may no longer do this. I assume that they can still rescind if you intentionally lie about big things, such as not mentioning that you’ve had cancer before.
Appealing Insurance Company Decisions
It’s happened to everyone – a bureaucrat decided to deny coverage for something the patient needs because the bureaucrat thinks it’s unnecessary. While you’ve always had the option to appeal, most people didn’t know that. The new law creates a formal external review process and a formal appeals process.
Eliminating Lifetime Limits on Coverage
A person with an expensive condition or illness will no longer be able to exceed their coverage. This often happened with cancer patients, but could also happen to patients taking expensive medications. Once they reached the cap, they either no longer had coverage or had to find a new job with a new plan. Experimental procedures may still be excluded, but necessary treatments must be covered regardless of the total dollar amount the patient has used. If you require expensive care and had previously exceeded the cap, contact your insurance company to see if you’re now eligible for treatment coverage under the new rules.
Restrictions on Annual Limits
In addition to lifetime limits, some insurance companies include annual limits on coverage. Those limits are now strictly curtailed and will be banned in 2014.
No Exclusions for Pre-Existing Conditions in Children
This is another big one. Prior to today, children with conditions such as asthma, leukemia, or birth defects could be denied coverage for a pre-existing condition if their parents had to change plants. Now, children under 19 can’t be denied coverage if they have a pre-existing condition for new plans and existing group plans. If you have a plan that excludes your child, you can now apply for new coverage for him or her.
As you can see, most of these new rules targeted the most egregious insurance company abuses or are items that most people can agree needed to be changed. The controversial stuff doesn’t take effect for quite some time.