Today, Thursday, September 23, 2010, is a banner day for Americans. Eight important reforms in the Patient Protection and Affordable Care Act went into effect. These reforms give Americans new rights and benefits, effective immediately. While all provisions of the law will be in place by 2014, today we can all rest a little easier because:
• Lifetime Limits have been abolished: Prohibits insurance companies from imposing lifetime limits on benefits so that Americans with private insurance coverage will never have to worry about their coverage running out.
• Preventive Health Services are now covered: All new plans must provide FREE coverage for over 100 preventive services, including mammograms for women over age 40, screenings for colorectal cancer for those over age 50, depression, smoking cessation programs, and autism for children age 18 months to 24 months.
• The Appeals Process has been improved: Requires that new group or individual health plans offer an effective process for appealing coverage decisions, such as refusals to cover procedures partially or at all. Consumers first file an internal appeal with their insurers, but if they are not satisfied they can appeal to an impartial reviewer.
• Rescissions are prohibited: Prohibits the abusive practice whereby health insurance companies rescind existing health insurance policies when a person gets sick as a way of avoiding covering the costs of enrollees’ health care needs.
• The ability to choose your own doctor has been enhanced: Expands consumer choice by ending the insurance company practice of limiting a consumer’s ability to choose a doctor in his/her own insurer network.
• Restrictions on Emergency Room care have ended: For new plans, consumers can no longer be charged more for emergency services obtained out-of-network.
• Pre-existing condition exclusions for children has been eliminated: Bars health insurance companies from placing pre-existing condition exclusions on coverage for children through age 18 for any new plans
• Coverage to young adults has been extended: Plans that provide dependent coverage to children must now make that coverage available until the child turns age 26.
We’ll keep a close eye on what’s changing and when. As for now, the next new round of improvements will take place on January 1, 2011. What a healthy way to celebrate the New Year!