The Patient Protection and Affordable Care Act or Healthcare Reform, is here. In 2014, various parts of the Act will begin and over time, it will become complete. Perhaps no bill in history has been more confusing and touched so many people.
Here are six basic provisions of the bill that as a consumer, you should be aware of.
1. Insurance can’t drop you if you get sick – One of the main reasons the healthcare act passed is because it was not uncommon for insurance companies to take your premiums for years, but cancel your policy when you faced a healthcare crisis. That is now illegal.
2. If a claim is denied, you have options – In the past, health insurance could deny payment, leaving you with little or no recourse. The new law makes this harder to do to policyholders. If a claim is denied, the insured can get an independent reviewer to look over the claim. If the claim is an Urgent Care situation, the reviewer must make a decision in 72 hours!
3. Lifetime limits on payouts are illegal – The new law bans caps on payments to cover an insured. Even in situations of chronic illness, there is no limit to the payout by your insurance company.
4. Annual limits banned – Just like lifetime caps, many insurance companies would limit the amount paid in a year. The new law changes that and now you do not have to worry your insurance limiting reimbursement within the year.
5. Companies can elect to pay fines – Businesses are not forced to comply with the new changes. Many companies are choosing to pay fines and fees for non-compliance instead of trying to comply to the regulations. Talk to your HR department to determine your company’s stance on healthcare reform.
6. Preventative care is free – The Affordable Care Act provides many preventative screenings, appointments and tests free. In an effort to encourage a proactive approach to health, the ACA has removed the barriers to yearly checkups and preventative care.