New healthcare protections
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.
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.