Health Insurance

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    AUnitedHealthcare Team, Administration, answered
    Yes. With the enactment of PPACA, persons who had not yet attained the age of 19 were immediately protected from the application of these exclusions. All other covered persons became protected from pre-existing conditions as of the first day of their plan or policy year beginning on or after January 1, 2014. These new rules do not apply in the case of individual plans that are “grandfathered” coverage. 

    While the new protections generally are effective for plan or policy years that begin on or after January 1, 2014, keep in mind that some individuals have coverage that that begins late in the calendar year. For example, it is possible that a plan year will begin on Dec. 31, 2014. This means that some individuals with health conditions may continue to be subject to a pre-existing condition exclusion under their plan or policy through the end of 2014.

    However, persons with health conditions may obtain coverage without pre-existing condition exclusions through the Exchanges or state based Marketplaces. If you have a pre-existing condition, and need health coverage, you should obtain information from your state’s Exchange, your state department of insurance, or the federal government’s health care internet site, www.healthcare.gov.
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    The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules establish federal requirements for keeping your health information secure. The HIPAA Privacy Rule generally requires healthcare providers and health plans to safeguard your health information. This requirement applies to both paper and electronic records. The HIPAA Security Rule more specifically details the steps your healthcare providers and others must take to keep your electronic protected health information secure.
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    The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule requires providers to assess the security of their electronic health record (EHR) systems. The rule sets technical safeguards for protecting electronic health records against the risks that are identified in the assessment. Some of the steps that may be taken to reduce the risks include:
    • Access controls such as passwords or PIN numbers that limit access to your information to authorized individuals, like your doctors or nurses
    • Encryption of your information, which means your health information cannot be read or understood except by someone who can decrypt it, using a key made available only to authorized individuals
    • Audit trails, which record who accessed your information, what changes were made and when they were made, provide an additional layer of security.
    • Workstation security, which ensures that computer terminals that can access your health records cannot be used by unauthorized persons
    Your providers must have risk management policies and procedures in place to assess security risks and to ensure that known risks are addressed and prevented.
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    Some websites offer a place to store your health records online. These are often called personal health records (PHRs). Some personal health records are offered by healthcare providers and health plans and are covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security and Breach Notification Rules. Other personal health records (PHRs) are offered by stand-alone companies. If these PHR companies are not covered by HIPAA, they must follow the Federal Trade Commission's Health Breach Notification Rule and notify you if there is a breach of your information.
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    Most of your healthcare providers and your health insurance company must give you a HIPPA notice, or a notice of privacy practice. This notice tells you how they may legally use and share your health information. It will also explain how you can exercise your health information privacy rights. The provider or health insurance company cannot use or disclose information in a way that is not consistent with its notice.
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    According to the Consumer Health Information Bill of Rights, you have the right to file a complaint about the way your health information is handled including, but not limited to, privacy and security concerns. You have a right to expect a timely response and resolution. A complaint or violation can be reported to the organization and/or other state or federal agencies.
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    According to the Consumer Health Information Bill of Rights, you have the right to expect that organizations will hold staff responsible for any improper access, use or release of your health information. You have the right to expect that a breach of your health information will be investigated as required by law. You can further expect to be notified of harmful breaches and assisted accordingly.
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    According to the Consumer Health Information Bill of Rights, you have the right to expect that protections are in place to keep your health information confidential and secure from unauthorized persons. You have the right to expect that your health information is exchanged securely across organizations. You also have the right to request that your provider contact you in the manner you prefer.
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    According to the Consumer Health Information Bill of Rights, you have a right to request a limit on the medical information released to others involved in your care or the payment of your care. Your provider has the right to deny the request, but must provide you with a reason if it cannot be met. However, a request to keep information from your healthcare insurer must be granted if you pay for the service in full at time of delivery.
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    According to the Consumer Health Information Bill of Rights, you have the right to a notice that explains how your health information is used. Your healthcare provider must give you a Notice of Privacy Practices that describes the possible uses and disclosures of your health information. You have a right to an accounting of disclosures (as required by law), which is a summary listing of who has received your information.