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On March 23, 2010, President Obama signed the health care reform bill, also known as the Patient Protection and Affordable Care Act (PPACA). Its goal is to lower health care costs, provide greater access to health care and enhance the quality of care Americans receive.
Some of the provisions that have been rolled out already include:
- Adult children are eligible for coverage under their parents’ group health plan up to the age of 26;
- Members under age 19 may be covered, even with pre-existing medical conditions;
- Certain preventive care services are covered at 100% when services are provided through an in-network provider;
- Lifetime dollar limits are no longer applied to Essential Health Benefits;
- Flexible spending account (FSA) dollars cannot be used to pay for over-the-counter (OTC) medications at a pharmacy, supermarket or other retail store without a prescription;
- A prior approval is not required before seeking emergency care at a network or non-network hospital.
One of the biggest changes will occur in October 2013, when people can begin to purchase and enroll in health plans offered through the health insurance marketplaces, for benefits effective January 1, 2014. The federal and state governments are setting up marketplaces in the states to offer a choice of health plans, with common rules and information to help consumers better understand the options available to them.
For more information on health care reform and how it affects you, go to healthcare.gov or uhc.com/reform.
This communication is not intended as legal or tax advice. Please contact a competent legal or tax professional for personal advice on eligibility, tax treatment and restrictions. Federal and state laws and regulations are subject to change.
Now that the Affordable Care Act (the Act) has been signed into law, you may be wondering what has changed and how it will affect your access to quality healthcare for you and your family. Much of that will depend on your individual circumstances and the established time line for implementing the various provisions of the Act.
Generally, the most significant changes are in the following areas:
- Expansion of Coverage - These provisions increase the number of people eligible for Medicaid, lay the groundwork for a marketplace where individuals and small business can buy insurance, and extend coverage for adult children up to age 26 on their parents' insurance plans.
- Consumer Protections - These provisions regulate insurance company practices that impact eligibility, including pre-existing conditions, limits on annual and lifetime benefits, and policy cancellations.
- Impact on Medicare - These provisions extend the life of the Medicare program by cutting waste and introducing efficiencies. They also expand coverage of prescription drugs, preventive services, and annual physical exams for people over 65, and scale back benefits in the Medicare Advantage program to reduce costs.
Gaining an understanding of these provisions of the new law will help you identify its impact on your access to care and your options for paying for that care so you can better identify and gather the resources and healthcare team you need to get better and stay healthy.
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.