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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Which health insurance reform changes take place right away?

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Question: I hear that most of the Health Reform changes won't happen until 2014. What, if anything, changes right away?

Answer: As you said, most of the big changes like no pre-existing conditions and premium subsidies won't go into effect until 2014. But there are some consumer protections that go into effect sooner.

If you've been denied health insurance because of pre-existing medical conditions, help will be available by July 2010.

  1. You will be able to enroll in a new federally subsidized major risk insurance program. The legislation appropriates $5 billion for this. Premiums will be subsidized, but It's not clear how much 0ne would pay as their share of the cost.
  2. Children's health insurance coverage cannot contain exclusions for preexisting conditions starting in September, 2010.

If you already have health insurance, these changes will take effect by October 2010.

  1. All existing insurance plans will be barred from imposing lifetime caps on coverage. Restrictions will also be placed on annual limits on coverage. What that means to you is your existing coverage, with a lifetime maximum of $2 mil to $6 mil will be amended to unlimited lifetime max.
  2. Insurers can no longer cancel insurance retroactively for things other than outright fraud. Previously, the insurance company could rescind your coverage if it appeared to them that you had omitted information or lied on the application. Sometimes, policies were rescinded after a provider submitted claims for serious illnesses like cancer. The insurance company then claimed that the insured certainly knew that he or she had symptoms or even a diagnosis of the disease and withheld that information on the application. Now, the insurer will have to prove that the applicant committed fraud by intentionally lying or withholding pertinent information on the application for coverage in order to rescind coverage. This makes your health insurance coverage much more secure.
  3. If your health insurance policy includes your children, you will now be able to keep them on your family policy until they are 26 years old.

For Medicare beneficiaries, some improvements in Medicare coverage will begin within months.

  1. Medicare beneficiaries who hit the so-called "doughnut hole" in the program's drug plan will get a $250 rebate this year. In 2012, the cost of drugs in the coverage gap will go down by 50 percent.
  2. Preventive care, such as some types of cancer screening, will be free of co-payments or deductibles starting in 2011.

Small business owners with fewer than 25 employees and average wages of less than $50,000 could qualify for a tax credit of up to 35 percent of the cost of their premiums for the 2010 tax year.

1 Comment

This new health law is really a monster of legislation, the dems have surpassed themselves this time

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