What Is In 'Obamacare': How Health Care Reform Laws Affect You

By Angie Parkinson
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Most people realize that the passage of the Affordable Care Act in March of 2010, also known as ‘Obamacare’, set in motion a series of changes that will impact how you access health insurance. What you might not know is the timeline for these changes or the ways in which they could affect you and your family.

Annual Caps

Insurance companies used to be able to set annual and lifetime limits on the amount of money they would pay out for the care of one person. That left consumers to pick up the tab for expensive treatments beyond those caps. The Affordable Care Act requires companies to phase out such limits over time, eliminating them completely by 2014.

Using Your Money

Starting in January of 2011, insurance companies must spend the majority of money that comes to them in the form of premiums on actual health care costs – 85 percent, to be exact, for large company plans and 80 percent for individual and small-employer plans. This money cannot be used for administrative costs or profit. It must be used to improve the health care of subscribers. If insurance companies do not meet these requirements, they have to provide rebates to their customers.

Pre-existing Conditions

Changes in health care coverage for people with preexisting conditions will happen in two phases. Starting in September of 2010, insurance companies cannot refuse to cover minors because of pre-existing conditions. Also as of 2010, the Pre-Existing Condition Insurance Plan makes coverage available to adults who are otherwise ineligible for most insurance because of ongoing health problems. That plan is meant only to bridge the gap for those usually uninsurable adults until January 2014, when the law changes to outlaw discriminating against people with pre-existing conditions. Insurance companies will not be allowed to refuse service to anyone based on their pre-existing conditions, nor can they charge higher rates due to gender or existing health conditions.

Preventative Care

Under the Affordable Care Act, adults have access to more free health screenings than ever. Any plan that started on or after September 23, 2010 must cover all of the following screenings and services without charging even a copayment: abdominal aortic aneurysm, aspirin, alcohol misuse, blood pressure, cholesterol, colorectal cancer, depression, type 2 Diabetes, diet counseling, obesity, sexually transmitted infection, syphilis, tobacco counseling and HIV screening. Adults also are covered for a long list of recommended immunizations. The list of covered screenings and immunizations is even longer for women and children.

Seniors also qualify for many more preventative services under new legislation. As of January 2011, those who are new to the Medicare system get a one-time checkup of their overall health without any expense to a senior patient. Longstanding Medicare participants also get free yearly wellness visits, which include counseling for things like smoking cessation as well as many health screenings – cholesterol, colorectal cancer, diabetes, mammograms, prostate cancer and more.

Summary

Regardless of whether you personally support the Affordable Care Act, you will most definitely be impacted by it. Familiarizing yourself with some of the coming changes will help you get the most from your medical insurance, whether you purchase it on your own or through your employer.

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