Today, September 23rd, 2010, is the day on which parts of the Affordable Care Act take effect. As of today:
Children up to age 26 can be kept on their parent’s employer health insurance. In Massachusetts this has been the law since Mitt Romney reformed health insurance there and required everyone to get covered. Parents will pay for this coverage, so it’s not free. Coverage for young adults is not expensive since most are very healthy and don’t go to the doctor. But many young adults have jobs without insurance or are finding it hard to find a job in these tough times. This is an inexpensive way to protect families from catastrophic medical bills if they have a sick child who would normally lose insurance coverage at 19 – or if they want to insure their 19-25 year old son or daughter just in case something should happen. One of the largest groups of uninsured Americans is young adults. This is a way to get them covered.
Insurance companies must offer insurance to children with pre-existing conditions. If a parent works for a small company that offers health insurance, he will be able to get his sick child coverage. Or if a woman is self-employed and has a child with a health problem, she can get insurance coverage for her child. Small group plans or family plans could previously refuse coverage to a child with certain conditions or illnesses. That is no longer allowed. The one catch is that the policies might be very expensive.
Insurers cannot charge you more for out-of-network emergency room care. If you’ve ever had a medical emergency while you were traveling and “out-of-network”, you probably had to fight with your insurance company and the emergency room over the bill you received. From now on, you will pay the usual co-pay that comes with your health insurance plan – if you have new insurance coverage.
Insurance companies can no longer cancel an individual insurance policy when a person gets sick. Previously, when a person got sick, the insurance company would do everything it could to find something in the initial application for coverage and could say something like, “Aha, you had a yeast infection as a teenager - which you did not put on your application. Now you have cervical cancer and we are canceling your policy because you did not divulge this pre-existing condition!” This is no longer allowed. This really happened to someone!
Lifetime benefits limits are being phased out. This is phased in over three years, so as of today new policies can cap lifetime benefits at $750,000 for the next year. Many insurance companies, like Blue Cross Blue Shield of Arizona, no longer have lifetime limits on their policies. Most policies I’ve seen over the last few years (from reputable companies) had limits of $3 million or $5 million.
Insurance policies must cover preventive care. This means that people who have a $5,000 deductible policy, which means they pay the first $5,000 for any and all medical care, can get preventive screening tests and the insurance company must pay for them.