New Health Insurance Rules: Free Preventive Careby Denise Early on Jul. 15, 2010, under Health
The Department of Health and Human Services has issued new regulations requiring private health insurance plans, beginning on or after September 23, 2010, to cover evidence-based preventive services and eliminate cost sharing requirements for such services. This means that health insurance plans beginning on or after September 23, 2010 must cover preventive services and may no longer charge the patient a copayment, coinsurance, or deductible for preventive services when they are delivered by a network provider.
Under these new rules, people who enroll in health insurance plans after September 23rd will be able to get a variety of preventive and screening tests fully paid for by their insurance company. Services covered will include screening tests for blood pressure, Diabetes, and cholesterol; many cancer screenings; routine vaccinations; pre-natal care; and regular wellness visits for infants and children.
Most legitimate health insurance plans, even individual plans, have already been modified to cover preventive services. And even high-deductible plans offered by companies such as Blue Cross Blue Shield of Arizona, Health Net, and Humana already allow enrollees to get preventive care that is not subject to their deductible. This means they pay a co-pay to see their doctor for preventive screenings, or they may not even have a co-pay for certain tests. I have called these insurance plans “legitimate” because people who pay premiums actually get some benefits for staying healthy and before they get really sick and have to use the “major medical” part of their insurance.
Companies that have offered “catastrophic coverage” health insurance are now dropping their plans. I got an email just yesterday from Assurant announcing their lowest priced plans (with very high deductibles) will take no more enrollments after August. In these plans a person pays premiums but must pay all of their medical expenses (doctor visits, lab tests, etc) until they hit the deductible amount, which is usually $5,000 or even $10,000. Then the plan becomes an 80/20 plan or a 70/30 plan, meaning the patient pays 20% or 30% of the medical bills.
The new rules for health insurance plans are part of the Affordable Care Act that was signed into law earlier this year. The health care reform law also applied these same rules on preventive care and screenings to Medicare and Medicaid. Medicare beneficiaries will now be able to get an annual physical and the screening tests mentioned above at no cost.