insurance

What health care reform delivers in 2010

Highlights
  • Insurance companies can no longer cancel your coverage after the fact.
  • Parents' insurance plans can cover young adult children longer.
  • Deductibles are eliminated for certain types of preventive care.

A lot of talk surrounding health care reform signed into law last month has focused on big changes coming in a few years. Such promises do little to help consumers who are at risk now of a financial meltdown resulting from high, out-of-pocket medical costs.

However, those living in fear of the health care bogeyman should take heart. These nine major provisions of health care reform right from the law should help to protect your family's coverage right away.

1. Pre-existing conditions phase out for kids.

Covers: Families with children.
Starts: Sept. 23, 2010.
What it does: Health insurance companies are banned from withholding coverage from children based on pre-existing conditions. Until 2014, insurers can still use such conditions as grounds for increasing parents' premiums. They just can't refuse coverage for their children.

2. Canceling coverage after the fact is no longer allowed.

Covers: All insured individuals.
Starts: Sept. 23, 2010.
What it does: The health insurance industry practice of retroactively canceling coverage based on mistakes or omissions in a patient's original application, known in the industry as rescission, will be illegal unless fraud takes place. Consumers won't have to worry about losing their coverage because of an error in paperwork.

3. Temporary high-risk pools will cover those with pre-existing conditions.

Covers: Adults with pre-existing conditions, making it difficult to find insurance.
Starts: June 21, 2010.
What it does: Health care reform provides a stop-gap, high-risk insurance pool for adults with pre-existing conditions that prevent them from buying insurance in the current market. Consumers who enroll in this pool will pay premiums similar to those paid by customers with no pre-existing conditions in the individual insurance market. Still, there will be variations based on age and lifestyle choices. Co-pays and deductibles will be limited to the current health savings account maximums of $5,950 for an individual and $11,900 for a family.

4. Parents' insurance plans can cover young adult children longer.

Covers: Young adults under the age of 26.
Starts: Sept. 23, 2010.
What it does: Before reform, young adults who reached the age of 19 were no longer eligible for coverage under their parents' insurance plans unless they were enrolled in high school or college. With health care reform, parents' insurance will cover their offspring up to age 26, allowing thousands of young adults without coverage to sidestep the pricey individual insurance market.

5. Health care reform begins to fill the Medicare Part D 'doughnut hole.'

Covers: Seniors covered by Medicare Part D.
Starts: Retroactive to Jan. 1, 2010.
What it does: The health care reform law raises the ceiling on initial government coverage by $500, shrinking out-of-pocket costs for seniors for their medication in 2010. Seniors that reach this increased limit will be mailed a $250 rebate check.

 

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6. Lifetime limits on insurance benefits banned.

Covers: All insured individuals.
Starts: Sept. 23, 2010.
What it does: Insurance companies can no longer impose a lifetime limit on benefits. Those struck by catastrophic and expensive illnesses need not worry about treatment grinding to a halt or having to pay huge out-of-pocket costs because their health insurance coverage runs out.

 

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