New Healthcare Law- Changes to medical insurance a win for consumers « Health Insurance Advisory

Welcome to the New Healthcare Law Center and State News

new healthcare reform lawThe 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.

In this section of the site, you can also obtain the following information specific to your state: available medical insurance options, efforts to regulate medical insurance premiums, healthcare, the individual medical insurance marketplace and the new healthcare law.

Our objective is to help Americans make sense of the new healthcare law by explaining key provisions in plain English and assisting individuals, families and the self-employed in using this information to find and secure affordable medical insurance.

New Healthcare Law- Changes to medical insurance a win for consumers

Author: Pete S - Sr. Staff Writer | Dec 14 2010 | General Provisions - New Healthcare Law

Many positive consumer protection mandates were enacted with the new healthcare law. The following major provisions of the new healthcare law, unless otherwise noted, became effective September 23, 2010, six months after the new healthcare law, called the Patient Protection and Affordable Care Act (PPACA), was enacted.  They apply to individual major medical insurance plans and employer group health insurance plans except where indicated.

  • Prohibiting Health Insurance Companies from Rescinding Major Medical Insurance Coverage- previously, if health insurers found an error or misstatement on a member’s application they could use it to deny payment for services when he or she got sick. The new healthcare law makes it more difficult to rescind major medical insurance coverage.  Now, coverage can only be rescinded for fraud or an intentional misrepresentation of fact.
  • Removing Annual Limits on Major Medical Insurance- similar to the mandate requiring the removal of  all lifetime maximums, the same also applies for covered benefits considered “essential” that have a calendar year maximum.   Under the new healthcare law, all employer group health plans and individual medical insurance plans effective on or after March 23, 2010 (or individual medical insurance plans that were effective prior to March 23, 2010 that make a benefit change and subsequently lose their grandfather status), any covered benefit considered “essential” cannot be subject to a calendar year maximum.  Additionally, the medical insurance policy must have at least a $750,000 calendar year maximum (this amount is indexed and increases every year).
  • Appealing Health Insurance Company Decisions- the new healthcare law establishes formal internal and external review processes designed to protect the consumer against an adverse claim or coverage determination by the medical insurance company.
  • Small Business Health Insurance Tax Credits- up to 4 million small businesses are eligible for tax credits during the 2010 tax year.  This is designed to help them pay for major medical insurance for their workforce. The first phase provides a credit worth up to 35 percent of the employer’s contribution toward the employees’ major medical insurance.  Small non-profit organizations may receive up to a 25 percent credit.
  • Relief for 4 Million Seniors Who Hit the Medicare Prescription Drug “Donut Hole”- an estimated four million seniors will reach the gap in Medicare prescription drug coverage known as the “donut hole” this year.  Each senior will receive a $250 rebate. First checks were mailed in June, 2010 and will continue monthly throughout 2010 as seniors hit the coverage gap.
  • Temporary High Risk Pool Program- individuals who have pre-existing conditions and have been without major medical insurance coverage for at least can enroll in the Pre-Existing Conditions Insurance Plan, call PCIP.  Each state is responsible for administering the program for their residents.  The plan covers pre existing conditions, limits the insured’s out-of-pocket exposure and caps the premium that can be charged.  It became effective June 23, 2010.

For more news and information regarding the new healthcare law, visit our healthcare reform information center.  We bring the world of health insurance to your fingertips.   For low cost medical insurance and online medical insurance quotes see www.healthinsuranceadvisory.org today.

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