Consumer Reports: The New Health Insurance Basics

[flpoljunkie]

The new health-insurance basics


New protections

Under the new health-reform law, insurers can no longer cancel your coverage if you get sick.

The health-reform law is changing the health-insurance marketplace in big ways. The first changes—those that happen right away—take effect Sept. 23, 2010, six months after the health-reform bill was signed. Many more will roll out over the next several years. Medicare and Medicaid are affected, too. Here's a health-insurance guide to how the new law affects you.


Changes that happen now

Preserves job-based coverage

If you get health insurance through work, your coverage will likely remain pretty much the same, but with some new consumer protections. Lifetime caps on coverage are banned, for example, and insurers will have to adopt new procedures allowing workers to appeal coverage denials.

Offers new protections for consumers

According to the new Patient's Bill of Rights insurers can no longer do the following: Cancel your coverage if you get sick; set lifetime limits on coverage; put annual dollar limits on coverage (this is phased in over three years); deny coverage to children under age 19 who have pre-existing conditions; and impose barriers to or refuse to pay for emergency care even if it's at a hospital outside the insurer's network.

Helps some uninsured people

Young adults can stay on their parents' insurance plans until age 26 instead of being taken off when they graduate from high school or college. Also, if you have been uninsured for six months and have a pre-existing medical condition, you can apply for coverage through new high-risk pools being set up in each state. The program will last until 2014, when other options kick in and insurers cannot discriminate on the basis of health status.

Offers relief to small businesses

Small firms don't have the bargaining clout big companies do, and they can be vulnerable to stiff premium hikes if a single employee needs expensive care. Thus, they often pay more for health insurance. Starting this year, businesses with up to 25 workers and average wages per worker up to $50,000 per year can get tax credits to offset the cost of insuring their employees.

Gives consumers more and better information

A new, easy-to-navigate government website, HealthCare.gov, lists and links to 5,600 insurance plans offered by more than 1,000 companies in all 50 states and the District of Columbia. Soon, you'll also be able to comparison shop by price on the site. Information on Medicaid and the state Children's Health Insurance Program (CHIP) is also available. Medicare's Hospital Compare website enables you to check up on the quality and safety of care at your local hospital, including infection rates.

Scrutinizes health-insurance costs

Starting in 2011 states will be responsible for enhanced review of health-insurance company rate increase requests. Also, insurers will have to spend 80 to 85 cents out of every premium dollar on medical care. If they don't, they have to rebate the extra amount to consumers.

For changes that start in 2014:

http://www.consumerreports.org/health/insurance/health-insurance/new-health-insurance-basics/health-insurance-guide.htm

[Mimosa]

1. The best part

"Starting in 2011 states will be responsible for enhanced review of health-insurance company rate increase requests. Also, insurers will have to spend 80 to 85 cents out of every premium dollar on medical care. If they don't, they have to rebate the extra amount to consumers."

[flpoljunkie]

2. Health insurance companies want R's to win so they can try and roll these things back--

They are pouring money into Republican coffers hoping somehow they can roll these requirements back. It will be difficult, if not impossible--even if the R's do regain control of the House.