On March 23, 2010, President Obama signed the Affordable Care Act. The following is a partial listing of key provisions of the new health care reform law that we implemented in the past few years.
What’s coming up in 2014:
Coverage for individuals participating in clinical trials
Insurance companies will provide coverage for routine patient costs for items and services furnished in connection with certain clinical trials when the criteria set by the government is met.
No more annual dollar limits
Health plans must provide benefits with no annual dollar limits.
No gender discrimination
Health insurers cannot charge you a higher or lower rate based on your gender.
Coverage with pre-existing conditions
Health insurance will cover pre-existing condition such as cancer, asthma, high blood pressure and arthritis.
All legal U.S. residents are required to have basic health insurance.
Financial help with tax credits or a subsidy
Depending on your income, you may qualify for financial help. To receive tax credits or a subsidy, you must check your eligibility for premium assistance through the Health Insurance Marketplace and not have access to affordable coverage through Medicaid, Medicare, TRICARE, the Veteran’s Administration or an employer-sponsored plan.
A look at some important events that happened in 2012-2013:
Electronic health records
Doctors, hospitals, and health plans share a secure electronic system to keep your records organized and available wherever you are.
More women’s preventive care covered
As long as you use a doctor in your insurance network, women do not have to pay for many preventive services.
A standard summary of benefits and coverage
Insurance companies must send a Summary of Benefits and Coverage (SBC) that can be understood by everyone. The SBC tells you what’s covered, what’s not, and your estimated cost for care.
Health Insurance Marketplace opens
Starting October 2013, you can use the online Health Insurance Marketplace as one way to purchase insurance.
A look at some important events that happened in 2010 and 2011:
Access to care
You can go to any ER for emergency care whether or not it is in your insurer’s network.
Coverage for children with pre-existing conditions
Children under 19 years old cannot be denied coverage because of a condition they had while being treated by another insurance company or before they were enrolled for health insurance coverage.
No lifetime dollar limits
Health plans must provide benefits with no lifetime dollar limits.
Coverage for young adults under 26
If your plan covers children, they can be added or kept on the health insurance policy until they are 26 years old.
Accountability for how your premium dollars are spent
To make sure that health insurers spend your premium on care rather than administration and overhead, they are required to spend at least 80-85 cents of every premium dollar to improve quality of care and pay claims.
Small business tax credits
If you have fewer than 25 full-time employees making an average of about $50,000 per year or less, you may qualify for employer health tax credits.