The new healthcare law, called the Patient Protection and Affordable Care Act (PPACA), represents comprehensive healthcare reform legislation signed into law on March 23, 2010. It contains numerous provisions designed to protect consumers and promote low cost medical insurance, including many new taxes to pay for the cost.The new healthcare law mandates that a variety of preventive care screening services are covered subject to no cost sharing. If your major medical insurance plan is subject to these new requirements, then you would not have to pay a copayment or coinsurance or satisfy a deductible to receive the covered services, which include preventive health screenings, vaccinations, and counseling.
This mandate is applicable to all individual and employer group medical insurance policies that became effective after March 23, 2010, the date the new healthcare reform legislation, called Patient Protection and Affordable Care Act (PPACA), became law. Most health insurance companies have modified their major medical insurance plans to cover these expanded services as of October 1, 2010.
If your current individual or employer group medical insurance is considered “grandfathered,” meaning it was effective prior to March 23, 2010, then it is not subject to this mandate and other PPACA requirements. However, if you modify the benefits, such as increase the deductible, copay and/or maximum-out-of-pocket, then the policy will lose its “grandfather” status. This will result in the health insurance carrier modifying your major medical insurance plan to comply with all PPACA mandates as of the date of the plan or benefit change is made effective.
An overview of the covered preventive care services can be found on HHS.gov, including the actual preventive care regulations that were written into the new healthcare law.
The preventive care services recommended by the U.S. Preventive Services Task Force with a grade of “A” or “B” are included in this new medical insurance mandate. A complete list can be found on HealthCare.gov in the Preventive Care Services section of the Implementation Center.
The new law also mandates coverage for routine immunizations for children, adolescents and adults, as recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) be covered. The detailed immunization schedules can be on the CDC’s website.
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