At least 600,000 young adults under age 26 have been added to their parents’ health insurance plans because of a provision of the Affordable Care Act (ACA), commonly known as the health care reform bill signed into law in 2010. In addition, thousands of people have registered this year for a new federally funded health insurance program for people with pre-existing medical conditions.
Health care reform is here, and the ACA is bringing to patients and family caregivers sweeping changes – some now and many more in the future. The legislation is long and complex largely because the health care delivery system in the United States is huge and complex, comprising nearly 18% of the nation’s gross domestic product.
For all Americans, there are benefits to knowing your rights under the new law.
Under the ACA, insurance companies cannot impose lifetime limits on essential benefits, such as hospital stays. You also won’t lose health care coverage based on an unintentional mistake made on an application. In the past, insurance companies could search for a technical mistake on a customer’s application and use this error to deny payment for services. The health care reform law makes this illegal.
What if you have filed a claim for your insurance company to pay for health care services and the claim was denied? The ACA strengthens patients’ rights to an independent review when an insurer denies a claim.
If you are a parent, it can be difficult at times – both emotionally and financially – to provide for a child’s medical needs. For example, Bryan was diagnosed with ulcerative colitis when he was in the eighth grade. At one point he was taking 12 pills a day to manage his condition. In middle school, he was diagnosed with Crohn’s disease. Because of ACA, children under 19 cannot be excluded from receiving health care insurance because of a pre-existing condition.
Good medical care also must include the basics – the preventive care services to make sure you don’t get sicker. Under the ACA, all new health insurance plans must cover certain preventive services — such as mammograms, colonoscopies, and blood pressure tests — without charging the patient a deductible, a co-pay, or a coinsurance.
There are numerous other provisions in the ACA. The first step to understanding the impact of the law on you and your family is to talk to your insurance provider or your employer’s human resources office. There are elements of the ACA already in effect today – and more in the coming years – that people and family caregivers should learn about today in order to live healthier and better lives. To learn more, visit these websites:
Insurance Information State by State:
For young people and the parents of young people:
For older Americans: