September 22nd, 2010
09:54 AM ET
Six months ago tomorrow, President Barack Obama signed landmark health care reform legislation. On Thursday, a wave of major changes will take effect. But how will that change your health insurance? Here are eight ways ...
1. If you are an adult under age 26, you will now be covered by your parent or guardian's employer-based health insurance. In some states, this coverage extends until age 28 or 29, CNNMoney reports. Some companies began covering these older dependents as early as May; the Department of Health and Human Services offers more information.
2. If you have a child under age 19 with a pre-existing condition, insurance plans can no longer deny coverage. If you're an adult with a pre-existing condition, you'll have to wait until 2014 - that's when insurance plans can't deny coverage to adults with pre-existing conditions.
3. Insurance companies can no longer drop any customer when that person falls ill. Insurers can't search out an error on your insurance application and then not pay for a service when you get sick.
4. Preventative services such as vaccinations, mammograms and colonoscopies must be covered under new plans; customers should not have to pay any deductible, co-pay or coinsurance on them. But if you keep your existing plans, or have a group plan that doesn't substantially change, this won't affect you.
5. Also, you won't have any dollar limit over the course of a lifetime on hospital stays or other essential benefits, according to the changes that take effect Thursday.
6. You may have more freedom in choosing a doctor: Pediatricians and obstetrician-gynecologists must be allowed to have primary care physician status, so you won't need a referral or prior authorization for those practitioners.
7. The appeals process for claims will be more accommodating for patients. Until the issue is settled, the insurer must keep paying your claims and subsequent treatment.
8. Going to the hospital for an emergency may be easier, too, as insurance companies can't make co-payments or co-insurance more expensive for out-of-network ER providers. They must also remove prior authorization for ER services.
Here's one that's already in effect: If you are a senior citizen, you will get a one-time rebate of $250, tax free, if you have Medicare prescription drug coverage and fall in the "doughnut hole." As of August 2010, 1 million rebate checks were sent, according to the White House's website.
To commemorate the six-month anniversary of the law, President Obama will travel to the home of a person with a chronic ailment who is benefiting from the provision about lifetime coverage limits, according senior administration officials.
The White House's website has more information on health reform in specific states. The organization Getting Covered is hosting events in several states to help inform people of what the changes mean. Here are more resources if you are uninsured.
Parija Kavilanz and Sabriya Rice contributed to this report.
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