Coverage of Preventive Health Care Required under Reform bill
In my ongoing quest to read the entire Patient Protection and Affordable Care Act page-by-page to see exactly what is inside. I have come across one of my favorite topics: Preventive Treatment. I give you…
SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES.
Basically this section says the insurance companies cannot “impose any cost sharing requirements” for certain preventive treatment. Meaning that insurance companies will have to foot-the-entire-bill for preventive treatment in the future if this bill stands. This is a huge provision and it is rarely, if ever, mentioned by the mainstream media.
Currently many health insurance plans require patients to pay for physicals, OBGYN visits and their related diagnostic tests until the member first satisfies their calender year deductible. That means that today most people pay for most preventive work with money out-of-pocket. Some insurance plans on the market today will request a doctor visit co-pay of say $40 but will not cover the related preventive lab work. It is rare to find a plan that has no doctor visit co-pay and covers all related diagnostic testing. The only examples I can think of are very expensive comprehensive HMOs and some of the high deductible HSA plans.
The tests that are covered under the new bill are designed to match the current recommendations of the United States Preventive Services Task Force. Unfortunately this site is a mess and it is unclear exactly what it covered and what is not.
Immunization are also required to be covered at no cost as long as they are recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention
When will Coverage of Preventive Health Services take place?
It is unclear when health insurance companies will have to offer full reimbursement of these preventive services.. The document says the minimum shall not be less than 1 year. Ok, so we know it won’t happen for at least a year. But what is the maximum time before this will be implemented on all health insurance plans. I haven’t figured that one out yet. If I do come across it I’ll post it up here.
Fun fact of the day: There is no such word as preventative. It’s preventive. Now you to can feel smug and correct others who mispronounce the word.
My next post: How this confusing to read bill will force health insurance companies to explain their benefits is a simple and standard way. Sounds like fun!
Comments and Questions
Click to leave a CommentComment from Stefanie on August 03, 2014
There is no such word as caldender. It’s calendar. Now you can feel smug and correct others who misspell the word.
Comment from Barbie on December 31, 2011
How could any of this be better satted? It couldn’t.
Comment from Douglas Thompson on April 21, 2010
Health Care Reform Act-intent for Change
For many years, America’s health brokers have been offering health insurance to individuals, small businesses and large businesses for decades, yet the enrollment statistics have revealed a steady decrease on an annual basis. The number of uninsured Americans is estimated to be as high as 30 million, and the Health Care Reform Act offers a solution. Not only will there be a higher enrollment number for America’s health brokers, but as of 2014, it will be required by law for every American to obtain health insurance. Every single American will be impacted by the New Health Reform Bill, making it one of the most important measures of the 21st Century.
Businesses
The main focus will be on businesses of 50 or more employees, in which they will be required to offer individual health plans, as well as family plans to all employees or face some stiff fines from the government. The amount comes to $2000 per uninsured employee, though there are exemptions to this fine. If you as an employer assist an individual with acquiring a personal health insurance plan through an open market called an exchange, then it would result in no fines. This only applies to an individual who makes a certain amount under the Federal Poverty Level, and the premiums are over 8% of his annual income.
America’s health brokers can rest easy in the fact that there will be expanded coverage, though there may be more competition. With the rise in individuals who will have health insurance, there may not be as large of a risk as one may assume. Though the new bill will require America’s health brokers to enroll individuals with pre-existing conditions, there will also be a new population of young individuals who will be insured with fewer health problems.
It is understood that larger companies already provide a group insurance plan (HMO, PPO) that covers all areas of needs for the population of employees. These policies will change very little, but there may be some changes in where the funding for the new health care plan will come. It is proposed that those making a certain amount of money, both individuals and couples, will be taxed at a higher percentage than others. This will provide money that can be used for the exchange and making sure that all individuals will be offered an affordable health plan.
There are still a few years before the plan goes into full effect, though some of the measures will be enforced immediately. There will be plenty of time to sort out the details and iron out the difficulties. As for the plan, anyone who does not have health insurance as of January 1, 2014, will be penalized a certain amount of money, and this amount could become worse if health insurance is continuously neglected. There has never been a better opportunity for America’s health brokers in terms of acquiring a new customer base-a broader customer base. Also, there has never been a better time in history for individuals being provided with the resources for the necessary medical treatment. This is a very unique time, with history in the making. Finally, there will be health care for all.