New Health Care Benefits That Take Effect TODAY!

Today marks the beginning of the earliest provisions of the new health care reform signed into law by President Obama on March 23. If you’re a little hazy about all of the provisions created by that law, check out 26 quick facts about the changes the health care industry.  For now, here’s a look at the new consumer protections that begin today.

No pre-existing condition exclusions for children below the age of 19 - Before today, children who developed or were born with a costly condition could be denied coverage by insurers. In addition to being less likely to receive crucial care for their condition, children in this category are much less likely to receive crucial vaccines and other preventative care.

The new law prohibits companies from denying coverage or services. For example, a company can no longer deny chemotherapy coverage because a child developed cancer before they were covered.

Insurers can no longer rescind coverage arbitrarily – Before today, insurers would routinely revoke coverage retroactively due to illness or unintentional paperwork errors on the part of employers. New regulations prohibit insurers from revoking coverage except in cases of fraud or intentional misrepresentation.

Insurers who want to cancel coverage must give 30 days notice to make time to appeal. There are no exceptions to this policy.

There are no longer any lifetime limits on coverage – Particularly for those who suffer from costly conditions from an early age, lifetime limits have the potential to rescind coverage exactly when a patient is most in need of care. No more, as of today.

Today begins the phase out of annual limits on the amount of care paid for by insurers – As of right now, no plan issued or renewed can set an annual limit below $750,000. This limit will rise to $1.25 million on year from today, and to $2 million two years from now. On January 1, 2014, all annual coverage limits will be prohibited.

Insurers are now required to accept any licensed, available primary care provider – Parents, for example, can choose any pediatrician to be their children’s primary care provider. Also, insurers are barred from requiring referrals for OBGYN care.

No longer can insurers limit you to a restrictive network of facilities, including those used for emergency care – Insurers are now barred from restricting access to emergency care or requiring approval for emergency care access, with the exception of a few plans that are grandfathered in.

These changers are likely to effect the cost of health for most Americans in the following four ways:

  1. Many experts expect a reduction in the “hidden tax” on insured Americans. The reasoning is that in the current system, the uninsured frequently receive emergency care that runs up costs that are never collected. This results in a markup for insured Americans, which should soon see itself reduced.
  2. By insuring high-risk risk individuals have insurance, fewer children should require expensive, avoidable hospital stays.
  3. Unexpected high medical costs contributed, in one way or another, to about half of the over half a million personal bankruptcies in the US in 2007. Many of these costs will now be borne by insurers, now that lifetime bans, annual bans, and pre-existing conditions are regulated.
  4. No longer will families be subject to “job lock” due to worries about losing health care. Now that pre-existing conditions are regulated, a parent needn’t worry about losing their children’s health care coverage when considering a better paying job. Also, with healthier children, parents will be less likely to use sick time to care for their children. That means a more active and vibrant economy.

There you have it, the care and financial benefits coming your way today – a host of regulations that result in fewer limitations on care. Now, you need no longer worry about health care running out or being rescinded when it could most hurt your livelihood.

Published or Updated: April 5, 2013
About Rob Berger

Rob founded the Dough Roller in 2007. A litigation attorney in the securities industry, he lives in Northern Virginia with his wife, their two teenagers, and the family mascot, a shih tzu named Sophie.

Comments

  1. RT says:

    “Insurers are now required to accept any licensed, available primary care provider”

    But that does not mean that any licensed provider is required to accept a particular insurance plans fees.

    “No longer can insurers limit you to a restrictive network of facilities, including those used for emergency care”

    Again those facilities will not be bound to accept the network fees of a particular insurance plan. I think that patients are now going to think they can go to any Primary Care and Emergency facility and they will end up getting huge bills in the mail for the portion their insurance company does not pay.

  2. jacqueline mcmickens says:

    Finally, America has gotten it right. There is no need for any American to be forced into bankruptcy because of health care cost. I cannot understand the Republicans wanting to repeal the Health Care Bill… who are these people?
    I wonder if they would support getting rid of Medicare and Medicade as well?
    I am hopeful that they country will see through the Republican’s plan to take back America. I think the last time they had it, it was almost given away…
    It was the present leadership of this Country, those elected Democratics (were there any Republicans) who had the courage say that universal health care for the greatest country on earth should be a reality, not since Roosevelt has there been such courage…… God Bless them!

  3. Anna Renault says:

    I’ll agree that the new health plan is not the greatest, but it is better than what we’ve had! AND it can improve quality of life — as well as a situation of facing life or death — with these new provisions. (Jacqueline, the previous comment — I AGREE with you about the threat of take back!)

    How many young adults 19-16 will take advantage of the coverage? HOW many of them are seriously ill or how many will SPEND the health care dollars? HOW much of these additional premiums will be PROFIT for the insurers?

    There is a PREVENTIVE CARE segment to the new laws. Having more people get preventive care should reduce the number of people who suffer from catastrophic illness at advanced stages — thus SAVING money AND saving lives. Getting people into primary care should also reduce the number of people who use Emergency Room visits as their primary care — thus SAVING money! Over time, wellness visits will pay for the “additional” cost!

    Premiums will increase! Well, when has my premiums NOT gone up over the past 40 years! And all those increases had nothing to do with the new health care reform bill.

    Yes, there are still some things that should be corrected in this new law; but in the long run — it’s the best thing to happen in medical care in many decades!

    would love to hear comments back about my opinions on the new health care bill!

  4. Linda Daniels says:

    Government employees has great insurance coverage, especially our congressmen and congresswomen. It is obscene that the opposition for healthcare for Americans is so adamant about denying benefits to every American eligible for healthcare. A national insurance propram is exactly what we need. I have great insurance, but I believe everyone else need the same benefit. With Medicaid some of the “spend-down” amouts are over half of the imcome of the insured. For example, if your income is $1565 per month, your spend-down can be as high as $950 per month before Medicaid pays a dime on your medical bills. How do you survive and pay living expenses? We need more reform. We need a national healthcare plan.

  5. Paul says:

    I agree we need this and republicans and everyone with tons of money should stop crying so much. Stop the lies recap on the news for a week before you send it out. How about no live news ever so it stops people from believing UNTRUE NEWS ABOUT HEALTH CARE FACTS ULTIMATELY STEALING AND FOULING PEOPLE INTO VOTING FOR REPUBLICANS AND/OR AGAINST UNIVERSAL HEALTH CARE.

  6. Cindy Garvey says:

    Hope these Republican’s don’t take this away from us. This healthcare plan is so needed right now. I think something should be done by the people of the USA to have insurance companies roll their prices back for insurance, Hospitals to roll their prices back, and pharmaceuticals to do the same. It has gotten way out of reach and people that are uninformed believe those politicians that tell everyone it is Obama’s fault. Obama just got into office. These prices have been going up up up for way to many years and no one did anything to stop them. We all just pay our bills and let them get away with it. A group should be formed to stand up to these 3 obstacles and make them roll back their prices. NOW

Speak Your Mind

*