New Provisions of the Health Care Reform Bill
In September 2010, major new provisions of the Affordable Care Act went into effect, putting an end to the worst of insurance company abuses. As we see the healthcare law fully implemented, insurance companies will not be able to deny any Americans coverage because we have a pre-existing condition--or drop us when we get sick. And that's just the beginning!
Keep reading below to find out more about how these new protections are benefiting you and your family.
Ban on Excluding Coverage to Kids with Pre-Existing Conditions
Insurance plans can no longer refuse to cover children younger than 19 because they were born with or develop a serious medical condition. (In 2014, a similar ban on coverage exclusions for adults with pre-existing conditions will go into effect).
Who does this benefit? Up to 72,000 uninsured children are expected to gain coverage by banning insurers from refusing them coverage due to a pre-existing condition. Up to 90,000 children will no longer be denied benefits because of a pre-existing condition.
Provides Free Preventive Care
If you join or purchase a new insurance plan, you'll receive recommended preventive care at no out-of-pocket cost. This will provide services like mammograms, colonoscopies, immunizations, pre-natal and new baby care without charging consumers a deductible, co-pay or coinsurance.
Who does this benefit? Up to 88 million people, who now have access to preventive care with no out-of-pocket costs.
Bans Insurers from Dropping Coverage If You Get Sick
In the past, insurance companies could search for an error or other technical mistake on a consumer's application and use this error to deny payment for services when he or she got sick. Now insurance companies are banned from cutting off your coverage due to an unintentional mistake on your application.
Who will this benefit? Approximately 10,700 people have had their coverage dropped in a given year because they get sick or make a technical mistake on their application. No more!
Extends Coverage of Young Adults on Parent's Plan
Young adults are now allowed to remain on their parent's plan until they turn 26 (unless they are offered individual coverage at work).
Who does this benefit? Up to 2.4 million young adults, up to 1.8 million who are uninsured and nearly 600,000 who purchase coverage in the individual market, have gained coverage through their parents.
No More Lifetime Limits on Insurance Coverage
Insurers are now prohibited from imposing lifetime dollar limits on essential benefits like hospital stays. By 2014, the use of annual dollar limits will be banned completely.
Who does this benefit? Up to 20,400 people, which is the number of individuals who typically hit their lifetime limits on the dollar amount that can be spent on coverage--along with the nearly 102 million enrollees who have policies with lifetime limits.
Freedom to Choose Your Doctors AND Your Emergency Room Care
Before reform, insurance companies could decide which doctor you could go to. Now if you purchase or join a new plan, you have the right to choose your own doctor in your insurer network.Who does this benefit? Up to 88 million people will benefit from these provisions that protects your right to choose a primary care provider & emergency room care.
Empowering Consumers to Appeal Insurance Company Denials
Before reform, when insurers denied you coverage or restricted your treatment, you were left with few options to appeal. Now the law provides consumers with a way to appeal coverage determinations or claims to their insurance company, and establishes an external review process.
Who does this benefit? Up to 88 million people will benefit from the new appeals process provisions by 2013.
Where to go for more information on these and other upcoming benefits of the new health care law:
→ SEIU's Health Care Reform Central
→ Health Care For AmericaNow.org
→ Healthcare.gov
→ Kaiser Health News

