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Most people who already have health insurance are not going to see a lot of change. Some of the changes affecting people who have insurance have already gone into effect and some of these changes are still being rolled out. The Affordable Care Act, or ACA, impacts people who are already insured by extending a parent’s insurance coverage to young adults up until the age of 26 and by prohibiting insurance companies from excluding coverage or limiting the benefits of having insurance.
According to the new healthcare reform preexisting conditions will no longer be a barrier to getting insurance. For insured parents of children with asthma or diabetes, this means that their children, who were often excluded before the new laws, can now be added to their policies and receive full treatment.
Benefits of the ACA extend to young adults that are living at home. Now young adults are eligible for full insurance coverage through their parents up until 26 years of age. This will provide coverage to the most injury prone age group in the United States and ensuring that young adults are covered through the school-employment transition period.
In addition to these benefits, health insurance companies will be required to provide more preventative care for free. . Such preventative measures can include but are not limited to blood pressure, diabetes and cholesterol tests, cancer screenings, smoking cessation counseling, routine vaccinations and flu shots.
For all insurance plans starting on or after August 1, 2012, preventative services for women will be covered without cost-sharing requirements. This means that women will have access to free preventative care through their insurance providers. These services include annual preventative care visits for adult women, gestational diabetes screening, HPV DNA testing, HIV screening and counseling, contraception and contraceptive counseling, breastfeeding support, supplies and counseling, and interpersonal and domestic violence screening and counseling. By eliminating cost sharing requirements, the ACA helps improve access to comprehensive quality care for all women in the United States.
In addition to the preventative benefits for women, the elderly can also qualify for yearly wellness visits and preventative services for free. Annual wellness visits are available to all beneficiaries who have had Medicare Part B for more than 12 months. This wellness visit would help develop a personalized prevention plan based on your health risk factors. Depending on the risk factors identified appropriate prevention plans can include tobacco use cessation counseling, diabetes screenings, cancer screenings, medical nutrition therapy and other services.
Lifetime and annual limits on certain benefits have been banned for all new insurance policies since 2010 and all lifetime and annual dollar limits will be phased out for all existing contracts by 2014.
The ACA also ensures that your premiums are spent on healthcare, making sure you get your money’s worth. This new law limits how much of your premium dollar your insurer can spend on things other than providing healthcare and improving its quality. Insurers selling policies to individuals or small groups must spend at leats 80% of premiums on direct medical care and efforts to improve the quality of care, and insurers selling to larger groups must spend 85% of premiums on care and quality improvement. Advertising, payrolls and other overhead should be paid from the unregulated 20%, and any excess is to be refunded to the customers. The first refunds are scheduled to take place during the summer of 2012.
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