Six months after President Obama signed the Patient Protection and Affordable Care Act, three major provisions of health care reform are set to take effect on September 23, 2010.
However, insurance plans that were already in place when the Affordable Care Act was signed can claim "grandfathered" status. These grandfathered plans are not required to provide some of the new law's consumer protections.
Here is a summary of those provisions:
1. No co-pay for pediatric preventive care for children with private insurance.
All pediatric well-child visits, including services such as physical examination, immunizations, hearing and vision screening must be covered by non-grandfathered insurance with no co-pays or deductibles for families. Non-grandfathered insurance also cannot exclude any of these services from coverage.
2. Eligible young adults will be able to remain on their parents' health insurance up to age 26.
Young adults do not need to be living with a parent, be a student, or be listed as an IRS dependent in order to be eligible.
3. The Patients' Bill of Rights takes effect.
Most annual and lifetime limits on insurance coverage are eliminated.
Insurers cannot deny care to children with pre-existing conditions.
The PBR applies to all new health insurance plans but not to grandfathered plans.
If you are interested in knowing whether your child's insurance plan will be following these and other provisions, I suggest that you contact your employer's benefits manager and/or call your insurance company directly.
The American Academy of Pediatrics (AAP) and other child advocacy groups have noted their concerns about the wide array of health insurance plans that are currently able to keep their grandfathered status. The AAP is lobbying to ensure that all plans, including those with grandfathered status, protect children's health.
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