What’s Coming Due to Healthcare Reform

by Team Dinks on October 13, 2010 · 1 comment

In March of 2010 the Patient Protection and Affordable Care Act, also known as “healthcare reform,” became law. Many of the big changes—like requiring everyone to have health insurance, prohibiting discrimination based on pre-existing conditions, and putting caps on the amount of coverage you can get—won’t kick in until 2014.

However, many reforms to our healthcare system have already begun. Let’s take a look at what changes have occurred and what regulations will take effect by the end of 2010. By the way, many of these regulations won’t apply to your health plan until it’s renewed (or if you get a brand new plan) after September 23, 2010. For most people, that means they’ll see the changes begin after the New Year.

What Are the Healthcare Reforms?

The healthcare regulations that have already started are aimed at expanding general services to those with low-income, to retirees, and to those in rural or underserved areas. The government is spending money to reign in fraud, to keep health insurance premiums as low as possible, and to promote the benefits of taking better care of ourselves. Here’s a summary of these new provisions:

Fighting fraud:  Health care providers will be subject to new screening procedures in an effort to weed out the massive fraud and waste that’s taking place in Medicare, Medicaid, and CHIP (Children’s Health Insurance Program).

Examining rate hikes: States that set up a system to make insurance companies justify premium increases will be eligible for $250 million in grant money.

Incentivizing health care workers: Uncle Sam wants more doctors, nurses, and physician assistants. They’ll be handing out scholarships and forgiving student loans tax-free for medical pros who work in underserved areas.

Promoting good health: The Prevention and Public Health Fund gives the government $15 billion to spend on programs aimed at keeping Americans healthy.

Expanding community health services: Funds are going toward the construction of new health centers and the expansion of services to patients.

Expanding Medicaid coverage: States are getting money to cover more individuals and families under Medicaid who weren’t previously qualified for the program.

Extending coverage for early retirees: Employers can participate in a $5 billion Early Retiree Reinsurance Program that covers retirees age 55 to 65 until they become eligible for Medicare.

Covering those with pre-existing conditions: The Pre-Existing Condition Insurance Plan will cover those who have been uninsured for at least six months due to a pre-existing condition. (This is a temporary measure until 2014, when coverage can’t be denied due to pre-existing conditions.)

What Healthcare Reform Started September 23, 2010?

At the end of September, on the six-month anniversary of the healthcare reform law, the newest round of regulations took effect. These consumer protections will help insure children, young adults, and make emergency room visits more affordable. Preventive care, like mammograms, colonoscopies, and vaccines, must now be covered without any copayment or deductible.

More provisions of the healthcare law will continue to roll out from 2011 through 2014. But for now, these are the changes that you should be aware of:

Covering children: Those under the age of 19 can’t be denied coverage due to a pre-existing condition.

Covering young adults: Children can now stay on their parent’s health plan until they turn 26 years old, unless they have their own workplace insurance.

Giving free preventive care: All new plans must cover certain services completely free of charge. Get a list of all the covered services at healthcare.gov.

Covering emergency room visits: Insurers must pay for emergency room services you receive from a hospital outside of your plan’s network.

Banning repeals in coverage: Insurance companies can’t rescind coverage due to a technical mistake on an application—they must prove fraud.

Eliminating coverage caps: Essential benefits, like hospital stays, can’t be subject to a dollar limit for lifetime coverage. Annual limits for certain services are restricted.

Establishing a review process: Consumers can appeal claims decisions made by their insurance company and have them reviewed externally.

Having health insurance is important not only for your physical well-being, but also for your financial health. Unexpected medical bills could devastate anyone’s personal finances. If you don’t have affordable health insurance through work, go to the Insurance Finder at healthcare.gov where it’s easy to compare plans and rates for private policies.

(Photo by kafkan)

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{ 1 comment… read it below or add one }

1 Dave@50plusfinance October 15, 2010 at 12:42 am

A nice list of benefits. They should offer a pre-medicaid plan because many people cannot afford to pay private insurance rates. I think what ever plan the government puts out only make health care more expensive. We are starting to see the results of our new health care starting to show up. I haven’t seen any rates decrease, only increase. I’m worried the rush job they did on the bill will come back to bite us later.

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