With the elections over and the new health care reform bill moving forward, there is a lot of talk and speculation about the new rules and regulations. As someone who lives with multiple chronic health issues, like Rheumatoid Arthritis, I'm very excited to see the changes that are coming our way! There are some great resources out there already on the internet but I wanted to help our community members here on HealthCentral get a quick overview of the changes that are happening with the passing of this new bill. Most of these changes are specific to private or individual health insurance and not Medicare or Medicaid unless noted.
CHANGES THAT AFFECT YOU TODAY
No Policy Cancellations - Insurance companies can no longer cancel your policy if you get sick, end up in the hospital or have any kind of new medical diagnosis or health crisis. That's right, your coverage cannot be cancelled for any reason!
No More Lifetime Limits - In the past, insurance companies could put a limit on the maximum amount they would pay for your medical bills. This is now illegal and ALL lifetime maximums have been changed to "unlimited" for everyone. Please note that until January 2014, insurance companies can still set limits on how much they will pay for an individual's medical expenses per YEAR, but this limit must be no less than $2 million. After January of 2014, these limits will be eliminated. This is a huge benefit for so many people with major or long-term illnesses.
Faster Appeals - If you are experiencing an urgent medical situation and need to appeal a decision made by your insurance company on care, you have the right to receive an independent review and a response with 72 hours.
Free Preventative Care & Annual Checkups - All new private health plans must cover the entire cost of yearly prevention checkups for individuals. These include yearly physical exams, immunizations, cancer screenings, pap smears, and "well woman" visits. Some existing plans may continue to charge for preventative care until 2014, but only if the plan hasn't changed since the passage of the law.
Young Adults Covered Until Age 26 - Young adults can now stay on their parents’ insurance policies as dependents until they turn 26, regardless of whether they attend school, live at home or are married. Note: there may be an exception if a young adult is provided coverage through their place of work. This exception goes away in January 2014. This change means an estimated 6.6 million young adults, who would have otherwise gone uninsured, will be covered within the next year.
Pre-existing Conditions - The new law has created a temporary program to help any adult who has been without insurance coverage for at least six months through the "Pre-Existing Condition Insurance Plan" (PCIP) in their state. Visit the PCIP website for more information and to see if you qualify. Note that as of January 2014, insurance companies CANNOT deny anyone coverage or charge more for premiums because of pre-existing conditions.