Heatlh Care Bill is Law But What Does That Mean? |

What does Health Care Reform Mean For You?

Posted by Todd Fries | Filed under Health Insurance

Now that Obama has signed the Health Care Bill into law, what does that mean for us? When does it go into effect?

Please call to discuss any issues you may have since there’s a lot of confusion around this new bill and I’m sure many of you have questions. Below are the fundamentals of what we know, but how all these changes ultimately unfold and when, only time will tell:

Children with pre-existing conditions can no longer be denied health insurance coverage, and adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary subsidized high-risk pool.

Health care plans will allow young people to remain on their parents’ insurance policy up until their 26th birthday.

Insurance companies will be banned from dropping people from coverage when they get sick, and they will be banned from implementing lifetime caps on coverage.

The bill creates a new, independent appeals process that ensures consumers in new private plans have access to an effective process to appeal decisions made by their insurer.

The bill provides funding to states to help establish offices of health insurance consumer assistance in order to help individuals in the process of filing complaints or appeals against insurance companies.

In the next fiscal year, the bill increases funding for community health centers, and government will establish an independent commission to advise on how best to build the health care workforce and increase the number of nurses, doctors and other professionals to meet our country’s needs.

Starting January 1, 2011, insurers in the individual and small group market will be required to spend 80 percent of their premium dollars on medical services. Insurers in the large group market will be required to spend 85 percent of their premium dollars on medical services. Any insurers who don’t meet those thresholds will be required to provide rebates to their policyholders.

Starting in 2011, this bill helps states require insurance companies to submit justification for requested premium increases. Any company with excessive or unjustified premium increases may not be able to participate in the new health insurance exchanges.

Reform immediately begins to lower health care costs for American families and small businesses:

Small businesses that choose to offer coverage will begin to receive tax credits of up to 35 percent of premiums to help make employee coverage more affordable.

New private plans will be required to provide free preventive care: no co-payments and no deductibles for preventive services. And beginning January 1, 2011, Medicare will do the same.

The bill will provide help for early retirees by creating a temporary re-insurance program to help offset the costs of expensive premiums for employers and retirees age 55-64.

The bill starts to close the Medicare Part D ‘donut hole’ by providing a $250 rebate to Medicare beneficiaries who hit the gap in prescription drug coverage. And beginning in 2011, the bill institutes a 50% discount on prescription drugs in the ‘donut hole.’

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