Several new health care reform provisions are being implemented next month and may affect your patients, and you as an insured member and/or employer. These new provisions include adjustments to how insurers define member eligibility and benefit coverage.
According to the law, insurance plans with an effective date of September 23, 2010 or later will need to comply with these changes and others. Plans already effective will need to comply after the group completes its next renewal cycle which is typically done annually.
Below are some specific changes rolling out in September, 2010:
- Adult children up to age 26 will be able to receive dependent coverage with all individual and group policies.
- Insurers will be prohibited from rescinding or canceling coverage except in cases where the customer commits fraud
- Insurers will not be able to exclude children from coverage because of a pre-existing condition. They can however, define limited enrollment periods to ensure parents do not wait until a child gets sick to buy coverage.
- Lifetime limits on the dollar value of insurance coverage will be prohibited. This refers to how much insurance coverage pays out to cover claims.
- Restrictions will be placed on annual limits for coverage, a practice that will be prohibited in 2014.
- Insurers will be required to provide preventive care like immunizations or mammograms without charging co-pays or other forms of cost sharing.
According to Jennifer Tolbert, a health policy analyst with the Kaiser Family Foundation, "These early provisions of the new law focus in part on consumer protections. It's basically improving the quality of coverage that people have."
For questions on how these changes may directly affect your insurance policy, please contact your health insurance broker/agent or health plan.
While there are a seemingly unlimited number of online resources offering various perspectives on the health care reform legislation and subsequent revisions, one option for information related to the legislation and its provisions is
http://www.healthcare.gov, an informational web site published by the US Department of Health and Human Services.
The law will continue to develop over the next several years and ChiroCare will continue to provide you with updates, tools, and key facts regarding the implementation of the health care reform and how it impacts you, your practice, and your patients.