How your health care may change
September 22nd, 2010
09:54 AM ET

How your health care may change

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.

Check out these stories of real people and how their health care may change. Tomorrow's Empowered Patient will provide more information about the changes that take effect Thursday.

Parija Kavilanz and Sabriya Rice contributed to this report.

soundoff (319 Responses)
  1. rastaMan

    There is nothing to FEAR but FEAR itself. Guns and Money. Our greatest FEAR is we wont enough of them. Yet America has more money then the next four countries combined and all the weapons on the planet. Still, we are AFRAID. What are we AFRAID of ? How come we dont FEAR stupidity as much ? This is all about FEAR. Reality is this is richest country on the Planet. Reality is we have POOR people and we have People WITHOUT HEALTH insurance. Reality is we are getting MORE and MORE AFRAID tighly correlated to our lower EDUCATION and educational standards. Forget Health Care. Send everyone back to SCHOOL !!

    September 22, 2010 at 15:22 | Report abuse | Reply
  2. maxtoo

    It's about time the U.S. moved toward a better health care system. The people who have posted here complaining about the changes are either uninformed, rich (very few, I suspect,) or just idiots. Western Europe, Japan, Canada, the list of countries who have more enlightened health care systems is staggering. Finally, we are moving into the mid-20th century. Those who don't like the changes should move to a country that reflects their preference in health care. Sudan?

    September 22, 2010 at 16:56 | Report abuse | Reply
    • Lee Oates

      Thank God, an intelligent comment. Thank you.

      September 22, 2010 at 17:41 | Report abuse |
    • Tired of DA

      You need to read a little more about those socialized health care systems!!!! My relatives in England say that it just doesn't work. Go figure!!

      September 22, 2010 at 17:52 | Report abuse |
    • Lee Oates

      Tired of DA: Bulls...t.

      September 22, 2010 at 18:04 | Report abuse |
    • Tired of DA

      What are you Lee???? A plant for BIG GOVERNMENT?????? I'm sure our founding fathers are rolling over in their graves. OR ?

      September 22, 2010 at 21:44 | Report abuse |
  3. Michael

    Leaving your health care concerns to profit driven insurance companies is going to change.Employers are not able to afford the premiums for their workers.Insuarance companies are raking in billions in profit and controlling the purse strings in healthcare.
    Government controlled option would be much better. Has anyone ever talked to a Canadian about their system? They do like it!!It's not perfect but it works. Essentially every developed nation ,except the US, has government healthcare. It works!! I applaud President Obama for having the courage to stand up to the insurance companies and their deep pocket lobbiest.I am ashamed of unfeeling Americans who only think of themselves and care nothing about the 50 plus million of us that have no insurance,but we go on paying our taxes and paying ever increasing cost of goods ,paying for your insurance coverage.You know someday the shoe may be on the other foot!!!

    September 22, 2010 at 17:06 | Report abuse | Reply
    • Lee Oates

      Now there is another intelligent comment. Let's hope this is a trend.

      September 22, 2010 at 17:43 | Report abuse |
  4. Lee Oates

    Reading all of the comments above, it is clear that there are a number of incredibly stupid and selfish people here, or a few company plants that are paid to simply object to anything that threatens the Medical Insurance Cartels....most likely a blend of both.

    September 22, 2010 at 18:09 | Report abuse | Reply
    • Tired of DA

      Like I ask earlier...what are you Lee??? A plant for BIG GOVERNMENT? Spend, spend, spend.........owe China more, more, more

      September 22, 2010 at 21:46 | Report abuse |
    • Lee Oates

      Nope...just an American/Canadian citizen tired of listening to a nation self-destruct, and sinking deep into self-pity. That's not the America I was raised in.

      September 23, 2010 at 04:24 | Report abuse |
  5. John

    God forbid we actually help those in need or provide health care to those people who ARE working and who's companies don't provide affordable healthcare. A few years ago my city voted unanimously to raise taxes for a new sports stadium because that's what was best for the city and the citizens lept for joy but if there's some misfortuned individual living around here withouth healtchare, screw 'em!! I find it humorous that the CBO (a non partisan budgetary committee) who's sole purpose in life is to review the congressional budgets and the effects of legislation on it determine that this healthcare legislation will actually reduce the defecit over time is just laughed away as some inside conspiracy. I suppose that's like the Republican denial of global warming because it snowed this year. Idiots. I'll give the Republicans one thing, they do love to shout the "truth" on forums like these and fake news shows like FOX, and I respect them for not letting pesky things like science and facts get in their way. Charge on tea baggers!

    September 22, 2010 at 18:41 | Report abuse | Reply
  6. twenty-somethingmom

    This isn't journalism! This is regurgitation of the white house's policy! Maybe your ratings would be better if you employed journalists instead of having the white house write your pieces. I expect a balanced piece. This legislation certainly has some positives, but to cite NONE of the negatives that go along with it? Do your job!

    September 22, 2010 at 20:56 | Report abuse | Reply
  7. Eric

    The 1st change shown above states coverage will be up to age 26 for dependent children of those with insurance. What has not been widely publicized is the fact that this does not apply to the military. Their cutoff is still age 21 unless enrolled full-time in college. An excerpt from the Tricare web page.
    "Typically, children remain eligible for TRICARE up to age 21 or age 23 if enrolled in college full-time and the sponsor continues to provide 50% of the child's financial support. Coverage ends on the child's 23rd birthday or at the end of that school year, whichever comes first. A child may be covered beyond these limits if he or she is severely disabled and the condition existed prior to the child's 21st birthday, or if the condition occurred between the ages of 21 and 23 while they were enrolled in college."
    Language placed in the bill specifically addresses this and screws the military families.

    September 22, 2010 at 23:52 | Report abuse | Reply
  8. Thoomas

    The biggest hurdle in getting and then keeping health care costs reasonable for everyone is the cost of the actual care. Hospitals and clinics cannot keep charging $75 for a Tylenol just because a nurse brings it to you. This is just one example of the bleeding of Americans that is rampant in our health care system. Insurance companies were part of the problem in that they worked in collusion with the actual providers. Other countries manage free health care (and their doctors are //still// well paid) because they don't allow price gauging. When you're sick and need the provider basically operates under the knowledge you (or your insurance) pay, or you die. This puts an undue burden on individuals either through staggering medical bills or jacked-up premiums.

    September 23, 2010 at 00:36 | Report abuse | Reply
  9. SK

    I say if you don't want health care reform and socialized medicine then the American people should stop paying for all govt workers including congress, federal, state, local, and teachers, fireman. police who get there health care paid for by the tax payer. I think Lee is right that the Canadian system would be just fine and everyone would have to support it through a sales tax. We could then get rid of all the insurance companies.

    September 23, 2010 at 06:56 | Report abuse | Reply
    • Sonny

      Not sure where you get that federal workers get free health care courtesy of the tax payer. We may have more options than the private sector, but we pay quite a bit for our health care just like the rest of the population and it has been going up exponentially over the 20 years I've been working. And, as for other health coverage that used to exist, such as for vision and dental, it is virtually nothing now. So, we are paying a lot more for health care insurance that covers less like you.

      September 23, 2010 at 09:23 | Report abuse |
  10. Jamie

    Somehow there should be dental coverage for those of us who don't have it and can't get it but need it. I am a single mother of a 5 year old and don't have the money to pay for a dentist and I do have medicaid but it won't cover me since I am over the age of 21. Dental coverage is something that we all need.

    September 23, 2010 at 21:09 | Report abuse | Reply
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