The Affordable Care Act (otherwise known as health care reform) was big news last year when it was the subject of a long fight in congress. But you may be surprised to find out that some aspects of the bill have already gone into affect.
Despite the natural resistance that comes with change, many of the new provisions could be a big help. Do you know how the new health care laws affect you?
Thanks to the new health care laws, your children can be covered by your insurance up to what age?
Correct Answer: 26.
Your children can be covered by your employer-based health insurance until the age of 26. According to CNNMoney, some states allow coverage to extend until the age of 28 or 29. Some companies already began covering older dependents as early as this May.
Children under the age of 19 can no longer be denied coverage for what kind of conditions?
Correct Answer: Pre-existing conditions.
If you have children under the age of 19 with pre-existing conditions, they can no longer be denied coverage when applying for health insurance. However, if youre an adult in a similar situation, youll have to wait until 2014, to enjoy the same kind of protection.
Insurance companies can drop a customer if that person falls ill.
Correct Answer: False.
Insurance companies can no longer drop customers if the customer falls ill. Insurers also cannot search out errors on your insurance application, and deny your coverage on the basis of a typo or honest mistake.
Which of the following must be covered by your insurance?
Correct Answer: All of the above.
Preventative services must now be covered under any new plans; customers should not have to pay any deductive, co-pay, or coinsurance on them. But if you keep your existing plan, or have a group plan that doesnt substantially change, the new law wont affect you.
What will be the standard for annual dollar limits on care, starting January 1, 2014?
Correct Answer: No limits allowed.
No annual dollar limits will be allowed on most covered benefits beginning January 1, 2014. The new law will restrict and phase out the annual dollar limits that all job-related plans can put on health benefits. Additionally, lifetime limits on most benefits are prohibited in any health plan or insurance policy that has been issued or renewed on or after September 23, 2010.
However, plans can put an annual dollar limit and a lifetime dollar limit on spending for health care services that are not essential.
With regards to doctor choice and ER access, you are allowed all but which of the following?
Correct Answer: No health plan barriers to any health specialists.
The new rules permit you to choose any available participating primary care provider as your doctor, prohibit health plans from requiring a referral for services from an OB-GYN specialist, and from requiring higher co-payments or co-insurance for out-of-network emergency room services.
In appealing a denial for claims, your insurance company must do all but which of the following:
Correct Answer: Give you a decision within 21 days for services for your children.
When an insurance plan denies payment for a treatment or service, you can appeal to the company to review its decision. If you decide to appeal, your insurer must give you its decision within a reasonable time frame: 72 hours for urgent care, 30 days for non-urgent care you have not yet received, and 60 days for service you have already received.
You can receive a $250 tax-free rebate from Medicare if:
Correct Answer: You must pay for your drugs out-of-pocket after you and your plan have spent a certain amount of money for covered drugs.
If you have Medicare prescription drug coverage, and have to pay for your drugs in the donut hole of coverage, you will get a one-time tax-free $250 rebate to help pay for your prescriptions. (The Donut Hole is when you have to pay for drugs out-of-pocket because you and your plan have already spent a certain amount of money for covered drugs.)
Early retirees must use their own savings to pay for health insurance until they are qualified for Medicare.
The Early Retiree Reinsurance Program will provide financial relief for employers so early retirees will receive quality, affordable insurance and not have to use their life savings on insurance in the individual market.
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