Given the recent signing of the Patient Protection and Affordable Care Act (PPACA), Americans should understand that it may take several years for the changes in the bill to be enacted. CDPHP remains an active advocate in the reduction of health care costs through innovative medical management initiatives.
For a summary of the entire health care reform bill, click here.
Changes effective for plan years beginning six months after the legislation’s enactment (September 23, 2010):
Existing individual and employer-sponsored health plans will be allowed to remain essentially the same; except they will be required to comply with the items below:
- Lifetime and annual limits on coverage, based upon dollar value of benefits will be prohibited.
- Prohibits cost sharing (i.e. copays, deductibles, co-insurance) for certain preventive services.
- For plans not in existence prior to March 23, 2010, mandates coverage for preventive services specified by the US Preventive Services Task Force; immunizations recommended by the Advisory Committee on Immunization Practices of the CDC; and preventive services and screenings as provided for in guidelines supported by the Health Resources and Services Administration.
- Young adults to age 26 will be allowed to continue on their parent’s family health insurance if the parent’s plan provides dependent coverage.
- Ensure access to a parent's health plan for children with pre-existing conditions and prohibit limitations on pre-existing conditions for children to age 19.
- Prohibits health plans from rescinding coverage from a member once a plan has been issued, except in cases of fraud or misrepresentation of material fact.
- Waiting periods for coverage will be limited to no more than 90 days.
To review a full outline of provisions of the bill effective in 2010, click here. To view the other resources offered by CDPHP, click here.
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