If you are uninsured or about to lose your health insurance, it
is important that you understand your choices, including pricing
information. It is also important to get health insurance
coverage and medical care before you need it to prevent the
worsening of your condition. Any condition or symptom left
untreated can lead to health complications that may be
life-threatening.
Most Americans get health insurance through a plan offered by
their employer or they buy it themselves from an insurance
company. There are many different kinds of private health
insurance policies and the benefits vary, depending on the plan.
On March 23, 2010, the federal healthcare reform legislation was
passed. All of the legislation’s provisions are being enacted in
phases through 2014. Below is a list of all of the components of
healthcare reform that impact consumers from 2011 until 2013.
2011
Seniors who reach the coverage gap will receive a 50 percent
discount when buying Medicare Part D covered brand-name
prescription drugs. Over the next 10 years, seniors will receive
additional savings on brand-name and generic drugs until the
coverage gap is closed in 2020. Download
a brochure to learn more.
The law provides certain free preventive services, such as
annual wellness visits and personalized prevention plans for
seniors on Medicare.
The Community Care Transitions Program will help high-risk
Medicare beneficiaries who are hospitalized avoid unnecessary
readmissions by coordinating care and connecting patients to
services in their communities.
2012
The law creates a voluntary long-term care insurance
program–called CLASS–to provide cash benefits to adults who
become disabled.
Californians who don’t have health insurance through work and
can’t afford to buy it themselves can find themselves negotiating
a maze of government-subsidized programs.
They might qualify for Medi-Cal, the state’s version of the
federal Medicaid program. They might be classified as a Medically
Indigent Adult, or MIA, depending on what county they live in and
what the income requirements of that county are, and get limited
health care services.
Three new maternity coverage laws were passed this year in
California, but that doesn’t necessarily mean the people who need
that coverage will get it, according to experts who gathered at a
recent meeting in the Capitol Building.
“Just passing a new law we found isn’t enough,” according to
Jenya Cassidy of the California Work and Family Coalition, which
co-sponsored the event. “It’s also really important that you need
to empower people to use the rights they have.”
According to Cassidy, many women of reproductive age who qualify
for services and protections under California law aren’t aware of
them.
Earlier this year, the governor signed three maternity-related
bills. AB 210 by Roger Hernandez (D-West Covina) and SB 222 by
Noreen Evans (D-Santa Rosa) require new insurance policies to
provide maternity coverage.
The percentage of U.S. adults without health insurance has
continued to rise even though provisions of the federal health
reform law that were designed to lower the uninsured rate have
been implemented, according to a Gallup poll released on Friday
[November 11, 2011], Politico reports.
A subsidized state health insurance program that offers
affordable coverage to people pre-existing health conditions hit
the 5,000-member mark by its first anniversary, far below full
enrollment.
Shopping for insurance has become an increasingly confusing
process. This article from Smart Money gives consumers
some easy-to-follow tips on how to make the process easier.
For months, government officials, health industry professionals,
policy experts and politicians have been debating what “essential
benefits” should be covered by health plans beginning in 2014
that participate in state insurance exchanges and in Medicaid
programs. The package, required by the health law, has raised
some critical questions:
The percentage of young adults without health insurance decreased
by about four percentage points since the implementation of a
provision in the federal health reform law allowing them to
remain on their parents’ coverage, according to a Gallup poll.
Reporting from Washington— The Obama administration Tuesday
[September 20, 2011] announced $109 million in grants to
states to help them beef up oversight of health insurers, a key
goal of the healthcare law the president signed last year.
Amanda Hite says she felt “really healthy” when she applied
recently for health insurance. But Anthem Blue Cross and Blue
Shield denied her, because she had seen a chiropractor a few
months earlier for a sore back and later had visited an emergency
room because of back pain.
Blue Shield of California is starting to make good on its promise
to cap its incomes at 2 percent and give back some of its 2010
profit to its policyholders.
More than half a year after one of the first pieces of federal
health care overhaul was launched, a fraction of those eligible
have enrolled for coverage in the Pre-Existing Condition
Insurance Plan.
Just 1,588 Californians and about 13,000 people nationwide have
signed up for the program that provides subsidized insurance for
people with ongoing medical conditions.
An estimated 4 million Americans and 250,000 Californians qualify
for the $5 billion, four-year program.
Ending what the Obama Administration called discrimination by
insurers against people with such medical problems was a prime
goal of the Affordable Care Act.
As a result of the federal Affordable Care Act of 2010,
California has a contract with the federal Department of Health
and Human Services to establish a federally-funded high risk pool
program called the California Pre-Existing Condition Insurance
Plan (PCIP). The PCIP offers health coverage to
medically-uninsurable individuals who live in California.
The program will last until December 31, 2013 when the national
health reform is set to begin.
State officials on Tuesday urged parents to sign up their
children for health insurance during an ongoing enrollment period
established by a new state law that requires private insurers to
offer children’s coverage under all their policies.
Health insurers, long under fire by consumer protection groups
for the practice known as rescission, now have the onus of
proving fraud before canceling the coverage of subscribers who
run up big medical bills.
The consumer protection, made possible by Assembly Bill 2470,
went into effect this year to conform with the federal health
care law, which as of last fall outlawed rescissions based on
innocent or minor consumer mistakes.
The new law is particularly important for the millions of
Americans who buy insurance on their own in the individual policy
market.
Defying California’s new insurance commissioner, Blue Shield of
California has refused to delay controversial health insurance
rate hikes that sparked an uproar among customers seeing
successive increases that could total as much as 59%.
Instead, the nonprofit insurer said it would submit its latest
increase — effective March 1 and averaging 15% — for review by an
outside expert.
A new system allows families to apply online for health care
coverage in California’s Healthy Families and Medi-Cal programs.
It also offers preliminary screening for Medi-Cal eligibility.
The Health-e-App consumer service can be accessed round-the-clock
from any location with access to the Internet.
The system was developed by the California Health Care Foundation
in 2001 and licensed to the state to help reduce the number of
uninsured children in California. It’s been used statewide by
workers trained to help people complete the application form.
Many employers offer discounts to workers who take steps toward
better health. This can cut costs and encourage wellness, but it
could also penalize those who can’t make the changes and yet will
pay more in premiums.
Individual health insurance policies generally don’t cover
maternity care, as a recent investigation by the House Committee
on Energy and Commerce reported. In an October memo outlining its
findings based on responses from the four largest for-profit
health insurers — Aetna, Humana, UnitedHealth Group and
WellPoint — the committee reported that most individual policies
at those companies didn’t cover most of the expenses for a normal
delivery.
Being healthy is important to everyone, but not everyone
can afford to pay for regular medical care. Government funded
insurance programs make it possible for many people to get the
healthcare they need so they can not only get healthy, but stay
healthy.
The federal legislation known as the Affordable Care Act was signed into law in March 2010. The law is designed to help millions of Americans obtain health insurance coverage. Under the new law, everyone must have health insurance. The reforms will cover more people and offer more benefits - more children will get coverage, elimination of lifetime limits and most annual limits on care, and gives many more people access to preventive healthcare services.
