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Some components of health care law begin to kick in

The nation's new health care law turns 6 months old today and starts delivering protections and dollars-and-cents benefits. But it won't affect all consumers the same way, which may cause confusion.

Will everyone's health insurance change today?

No. It depends on when your health insurance plan year starts. Many of the new requirements begin with plan years starting today or after. But if your plan year starts Jan. 1, as many do, that's when the changes start.

"Grandfathered" plans, those that existed before the law was enacted March 23 and remain essentially unchanged, must meet only some of the requirements. New plans and those with significant changes in benefits or out-of-pocket costs must comply with even more changes in the law.

How do I know how my health plan fits in all this?

If you get insurance through work, ask your employer. If you buy insurance yourself, call your insurance company.

What are some of the new benefits?

Free preventive care, for one. Some people will no longer have to pay copays, coinsurance or meet their deductibles for preventive care that's backed up by the best scientific evidence. That includes flu vaccines, mammograms and diet counseling for adults at risk of chronic disease. New plans, and those that change substantially today or after today, must provide this benefit.

What other changes start today?

If you go to an emergency room outside your plan's network, you won't get charged extra. Patients will be able to designate a pediatrician or an ob-gyn as their primary care doctor, avoiding the need for referrals that are required by some plans.

What about lifetime limits?

Millions of Americans have insurance that sets a cap on what their insurance will pay over a lifetime. The caps have left very sick patients high and dry. Lifetime limits will be eliminated for plans issued or renewed today or later. Those who have maxed out because of caps but remain eligible for coverage must be reinstated on the first day of the plan year that begins today or later.

What about annual limits?

Plans issued or renewed today or later can't have annual limits lower than $750,000. Annual limits will be eliminated entirely by 2014. Exceptions: Employers and insurance companies can apply for waivers for so-called "mini-med" plans that offer limited benefits so people don't lose their health coverage when premiums go up.

Do any changes affect parents?

Insurers can no longer deny coverage to children with pre-existing conditions. Parents can keep their adult children on their health plans until age 26.

Any other consumer protections?

The law bars insurers from canceling policies retroactively when a person gets very sick and runs up high bills. Insurers still will be able to rescind policies in cases of fraud and intentional misrepresentation.

Why today?

Today marks six months after President Barack Obama signed the law. Many provisions were scheduled to start six months after enactment.

Will these changes raise health insurance premiums?

The Obama administration says the new benefits will raise premiums by no more than 1 to 2 percent. Benefit consulting companies say the impact will be in the single digits, but may vary.

Some components of health care law begin to kick in 09/22/10 [Last modified: Thursday, September 23, 2010 7:05am]
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