Ask Kim
Health-Care Reform Provisions Kicking In
Several changes created by the new law, such as an end to lifetime-coverage limits, took effect September 23.
By Kimberly Lankford, Contributing Editor, Kiplinger's Personal Finance
September 23, 2010
I’ve been hearing a lot about the six-month anniversary of health-care reform, and I know that a few parts of the new law are supposed to take effect then. What is changing?
September 23 marks the six-month anniversary of the landmark health-care-reform law, when several key provisions kick in. Despite the hoopla, most consumers won’t notice changes in their health-insurance coverage until the beginning of the next plan year (generally January 1 for most people who get their insurance at work). Here’s what to expect if you have employer-based coverage. The rules and deadlines are slightly different if you buy your insurance on your own. I’ll cover changes that affect individual policies in my next column.
New coverage for kids big and small. One of the biggest changes in the new health-care-reform law is that parents can keep their adult children on their policies up to age 26 (or add them back on to the policy if they had dropped off because they were too old). The rule takes effect in the plan year that starts on or after September 23 (which is January 1 for most employer policies). See Keeping Adult Children Insured for more information about this rule.
Even though coverage won’t begin until January 1, 2011, most families who want to take advantage of this new provision have to act soon: You’ll need to add your child to your policy during open-enrollment season this fall. See Health Insurance Changes for 2011 for more information about open-enrollment decisions.
If you already have family coverage for younger children, adding an adult child to your policy probably won’t cost you extra. But if your employer charges separately for each dependent, it might be cheaper for your adult child to get his own policy. Healthy adults in their twenties can usually buy a policy in most states for less than $100 a month. You can shop for a policy through eHealthInsurance.com, get a list of policies available in your area at www.healthcare.gov, or find a local agent at www.nahu.org.
Younger children also get new protections under the new law. Insurers are prohibited from denying coverage to children under age 19 because of a preexisting medical condition, which applies to most plans on January 1.
Free preventive-care benefits.Many people will no longer have to pay co-payments, coinsurance or meet deductibles for routine preventative care. Depending on your age, this rule may apply to blood-pressure, diabetes and cholesterol tests, mammograms and colonoscopies, flu shots, routine vaccines, and well-baby and well-child visits. While free preventative-care benefits will be available in many employer-based plans beginning January 1, there are exceptions.
For example, these benefits may not apply if you have a “grandfathered” plan. Some existing health plans that have not made major changes to their costs and benefits since health-care-reform was enacted are not subject to some of the consumer protections that new plans or non-grandfathered plans must follow. Ask your insurer whether your plan is considered to be “grandfathered” -- the key word to use to find out whether some of these new provisions will apply to you."
Lifetime-coverage limits disappear. Health plans will no longer be allowed to impose a lifetime dollar limit on most benefits. In the past, seriously ill patients with health-insurance coverage could be on the hook for enormous medical bills once they exhausted their benefits. Annual limits will be phased out gradually between now and 2014. For plan years starting between Sept. 23, 2010, and Sept. 23, 2011, employer plans can’t impose annual coverage limits of less than $750,000 (the limit rises to $1.25 million for plan years starting after Sept. 23, 2011).
For more information about health-care reform, see our special report, Health-Care Reform: What It Means to You.
Topics:
- Comments
- RSS
Permission to post your comment is assumed when you submit it. The name you provide will be used to identify your post, and NOT your e-mail address. We reserve the right to excerpt or edit any posted comments for clarity, appropriateness, civility, and relevance to the topic.
View our full privacy policy
Reader Comments (7)
Posted by: JD at 09/28/2010 07:53:02 PM
Calling it "Health Care Reform" is politically biased and deceptive. It plays into the argument made by the ACA's supporters that you either had to support their bill or be opposed to any reform at all. This was a false choice. The name they gave it, "Affordable Care Act", is biased enough as it is. I would rather call it ObamaCare - a name that clearly identifies it, associates it with its key proponent, but doesn't imply bias.
Posted by: mike at 09/28/2010 08:21:14 PM
...the problem with everything you've noted carries an addition cost in premiums. Also, it will carry an addition cost in deductibles So while you say oh isn't it good no copay on this test or that test, the result will be higher premium's and higher deductibles. Also, higher out of pocket cost for drugs etc. The average person with healthcare today will see a reduction in coverage and at least $2000 out of their costs for implementation of this health care reform.Why aren't you honest about those cost?
Posted by: bob at 09/29/2010 08:05:23 AM
Yes health care provisions have already kicked my butt in. A 25% increase in my premium, a reduction in my HSA allowance to $2,500 and my doctor that I liked retired because he wasn't making as much as his plumber. I am now getting letters from the CDC wanted my kids immunization records and medical history, sorry to tell you this is not going to happen!
Posted by: ynottony at 09/29/2010 11:28:17 AM
its not the cost this year. neither is it in 2011. but watch out for 2012 when the bean counters figure out how much more this is going to cost because of the "free" exams and treatment. the premiums and/or deductibles will skyrocket. perhaps in BHO's words: "necessarily skyrocket" (albeit he used the term as applies to our utility costs - which, with the EPA's new rules, will in fact skyrocket!) WAKE UP AMERICA. there is no free lunch. never has been. never will be.
Posted by: Ron Doty at 09/29/2010 08:10:45 PM
"Despite the hoopla, most consumers won’t notice changes in their health-insurance coverage until the beginning of the next plan year." Oh really? My premiums just took at $165 monthly leap. That is what happens when business forecasts future losses, it banks money to pay for them. 30 Million additional people are not going to be insured for free. I am going to help pay for it.
Posted by: Kelly Mumma at 09/30/2010 02:05:40 PM
It was on the news last week that mammograms would have to be paid up front at 100%of the cost. Is this correct?
Posted by: Robert at 09/30/2010 08:46:23 PM
"30 million additional people are not going to be insured for free. I am going to help pay for it." You're a good man, Ron Doty. Thanks. This is exactly how advanced, compassionate, united societies work.