New health­care pro­tec­tions

Los Angeles Times - - The Nation -

Sev­eral ma­jor new con­sumer ben­e­fits took ef­fect Thurs­day on the six-month an­niver­sary of the health­care law signed by Pres­i­dent Obama in March. The ben­e­fits ap­ply to plan years start­ing on or af­ter Sept. 23. Be­cause many peo­ple are in health­care pro­grams with plan years that be­gin Jan. 1, they will not see the new ben­e­fits for three more months.

Ban on rescis­sions: In­surance plans may not ter­mi­nate cov­er­age when con­sumers get sick.

Guar­an­teed cov­er­age for sick chil­dren: Plans that cover chil­dren may not deny cov­er­age if a child is sick or ex­clude cov­er­age of a pre­ex­ist­ing con­di­tion.

Cov­er­age for adult chil­dren: Plans that pro­vide de­pen­dent cov­er­age must al­low par­ents to keep their chil­dren on their plans un­til the chil­dren turn 26. Ban on life­time lim­its in cov­er­age: Plans may not im­pose life­time caps on the dol­lar amount they will pay for con­sumers’ care. Re­stric­tion on an­nual limit: Plans may not place an an­nual cap lower than $750,000 on what they will pay for ba­sic ben­e­fits. The cap rises to $2 mil­lion in 2012.

No-cost pre­ven­tive care: Plans may not re­quire co­pays or de­ductibles for many rec­om­mended pre­ven­tive ser­vices, such as im­mu­niza­tions, mam­mo­grams and other can­cer screen­ings. Ex­panded ap­peal rights: Con­sumers whose claims are de­nied will be guar­an­teed an in­de­pen­dent ex­ter­nal re­view of the de­nial. Ex­panded ac­cess to doc­tors and emer­gency care: Plans may not re­quire pre-au­tho­riza­tion for emer­gency care ser­vices and ob-gyn care.

Joe Raedle

IN MI­AMI: Dr. Lee San­ders ex­am­ines Aal­liyah Ne­gron, 6, as her sis­ter Jense­nia Bonilla, 4, and mother, Gla­dys Bonilla, look on. The new health­care law will ben­e­fit Aal­liyah, who has pre­ex­ist­ing con­di­tions.

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