Health Insurance Starts Working Better for Maine Children and Families
The comprehensive health care reform that Congress passed in March 2010 just
reached its first milestone. On September 23rd health insurance started to work
better for individuals and families across the country. Several important new
protections that will improve coverage for millions of Americans went into effect.
Here are the parts of the new law that take effect now. These changes mostly
affect coverage through private health plans. In many instances you may have
to wait until the next “open enrollment” or your plan’s renewal
date.
Sick children can’t be denied coverage. Children under
age 19 with private health insurance can no longer be denied coverage for pre-existing
conditions. In 2014, this will apply to all adults as well.
Health coverage extended to young adults. Young adults up
to age 26 will be allowed to stay on, or be added to, their parent’s family
policy. Your child does NOT need to be financially dependent on you. Your child
would also not be required to live with you, be unemployed, unmarried, or be
a student.
Ending lifetime and annual benefit limits. Insurance plans
can no longer have lifetime caps or restrictive annual limits on coverage. They
are also banned from cutting off your coverage due to any unintentional mistakes
on your application.
Free preventive care. New health plans will have to cover
preventive services such as annual physicals, immunizations, prenatal and new
baby care, and mammograms and other screenings with no co-pays or deductibles.
Easier access to primary care. The new law protects your choice
of primary care doctor and allows women to go directly to their OB/GYN without
a referral.
No added fees for emergency care. Health plans and insurers
will not be able to charge higher amounts for emergency services that are obtained
out of a plan’s network. And, don’t forget the changes that went
into effect in June 2010!
Health coverage for people with pre-existing conditions. If
you have been diagnosed with a serious medical condition and have been uninsured
for six months or more, you may qualify for health insurance. Here in Maine,
you can apply to the Pre-existing Condition Plan through DirigoChoice. Get more
information from the Dirigo Health
Agency at 1-877-892-8391 (TTY 1-207-287-4344).
Lower prescription costs. A $250 rebate is being issued to
people enrolled in Medicare Part D who reach the doughnut hole. This means that
seniors are getting some help paying for the medications they need. Starting
in 2011, they will get a 50% discount on brand-name drugs and reductions in
the cost of generics in the doughnut hole. Bit by bit, over the next few years,
the doughnut hole will go away.
With these changes, the Affordable Care Act passed by Congress in 2010 is bringing
health care coverage to more individuals and families in Maine and across the
country. As other parts of the health care law are phased in over the next three
years, thousands of hard-working individuals and families in Maine will finally
have access to affordable, quality coverage. Please stay tuned. MEJP will keep
you informed as these changes occur.
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