Insurance Changes with Health Care Reform | Netchex HCM Software
September 10, 2013

Portions of President Obama’s Patient Protection and Affordable Care Act have already been implemented, and the remainder will go into effect in January 2014. With so much media hype surrounding this act, you may have found it difficult to determine just how this will impact you as a person receiving health insurance through your employer. Read on for some highlights of the new policies and procedures.

The changes listed below are currently in place.

  • Insurers no longer have the right to cancel your insurance policy if you make an honest error on your application or if you become ill.
  • Consumers now have the right to a 72 hour turnaround on appeals to insurance companies for urgent medical situations.
  • Insurance companies may no longer set lifetime limits on how much they will pay for an individual’s medical bills.
  • New private medical plans must eliminate co-pays for medically proven preventative measures such as immunizations and cancer screenings.
  • Women are now entitled to free well-woman visits, screening for gestational diabetes, domestic violence screening, breast feeding supplies, and contraception, all without a co-pay.
  • Insurance companies must spend a minimum of 80-85 percent (depending on the size of the employers they are covering) of the premiums they collect on patient care and quality improvements, instead of administrative costs such as employee salaries.
  • Children may now remain on the health insurance plan of one of their parents until age 26, regardless of if they are married, in college, or live at home.The following changes will be implemented in 2014.
  • While insurance companies may still set limits on what they pay for an individual yearly, that limit must be no less than 2 million dollars per year.
  • Insurance companies must cease denying coverage or charging higher premiums to those with pre-existing conditions.

This is a very brief overview of the Act and is not mean to be all-encompassing. An excellent source for additional information is the federal government website

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