Thursday, September 23, 2010

Health Reforms Go into Effect TODAY affecting young adults, sick children and preventive care

Today, September 23 2010, is exactly six months since the Patient Protection and Affordable Care Act became law. (This law is commonly referred to as the federal health reform law.) On this important day, several provisions of the law go into effect for the first time.  These reforms will make it easier for young adults and sick children to get health insurance. The law will forbid insurance companies from dropping coverage of enrollees because they became sick and encourage preventive care by requiring health insurance companies to offer many preventive services for free, without co-pays or deductibles.

Provisions Going Into Effect TODAY:
  • Health plans that cover families must allow enrollees' children to stay on their parents' health insurance policies until they turn 26 years old, regardless of whether they are married, in school or financially dependent on their parents. See for more information.
  • Insurance companies may not deny coverage to children under the age of 19 due to a pre-existing condition.
  • Most health plans are required to offer preventive services such as immunizations, screenings and well-child appointments without charging a copayment, co-insurance, or deductible. See for more information.
  • It is now illegal for insurance companies to search for an error, or other technical mistake, on a customer’s application after they become sick in order to deny payment for services. 
  • The law sets up a way to appeal coverage determinations or claims to insurance companies and establishes an external review process.
  • Insurance companies are prohibited from imposing lifetime dollar limits on essential benefits like hospital stays.
  • Insurance companies’ use of annual dollar limits on the amount of insurance coverage a patient may receive are restricted for new plans in the individual market and all group plans. 

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