Health and Wellness: The Affordable Care Act

The Affordable Care Act expands medical coverage for millions of low income Americans and small business owners. This new law finally put people back in control of their health care. Here are the most important things you need to know about the new law:
Children Pre-Existing Conditions - Under the Affordable Care Act, health plans cannot limit or deny benefits or deny coverage for a child younger than age 19 simply because the child has a “pre-existing condition” that is, a health problem that developed before the child applied to join the plan.
This means for those interested under the new health care law, plans that cover children can no longer exclude, limit, or deny coverage to your child under age 19 solely based on a health problem or disability that your child developed before you applied for coverage.
This rule applies to all job-related health plans as well as individual health insurance policies issued after March 23, 2010. The rule will affect your plan as soon as it begins a plan year or policy year on or after September 23, 2010.
Children Pre-Existing Conditions - Under the Affordable Care Act, health plans cannot limit or deny benefits or deny coverage for a child younger than age 19 simply because the child has a “pre-existing condition” that is, a health problem that developed before the child applied to join the plan.
This means for those interested under the new health care law, plans that cover children can no longer exclude, limit, or deny coverage to your child under age 19 solely based on a health problem or disability that your child developed before you applied for coverage.
This rule applies to all job-related health plans as well as individual health insurance policies issued after March 23, 2010. The rule will affect your plan as soon as it begins a plan year or policy year on or after September 23, 2010.

Young Adult Coverage - Under the Affordable Care Act, if your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 years old.
The new health plans that cover children must make coverage available to children up to age 26. By allowing children to stay on a parent's plan, the law makes it easier and more affordable for young adults to get health insurance coverage. A child can join or remain on a parents plan even if they are:
· Married
· Not living with the parent
· Attending school
· Not financially dependent on you
· Eligible to enroll in their employer’ s plan
Plain Language Benefits Information
As of September 23, 2012 or soon after, health insurance issuers and group health plans are required to provide you with an easy-to-understand summary about a health plan’s benefits and coverage. The new regulation is designed to help you better understand and evaluate your health insurance choices.
The government knows it’s not easy for consumers to know what they are buying when shopping for insurance. The Department of Health and Human Services standardized the law and made the new law easy to understand, so the information about health plan benefits and coverage allows you to more easily make “apples to apples” comparisons among your insurance options. The measure brings more openness to the insurance marketplace for the more than 180 million Americans with private health coverage.
The new health plans that cover children must make coverage available to children up to age 26. By allowing children to stay on a parent's plan, the law makes it easier and more affordable for young adults to get health insurance coverage. A child can join or remain on a parents plan even if they are:
· Married
· Not living with the parent
· Attending school
· Not financially dependent on you
· Eligible to enroll in their employer’ s plan
Plain Language Benefits Information
As of September 23, 2012 or soon after, health insurance issuers and group health plans are required to provide you with an easy-to-understand summary about a health plan’s benefits and coverage. The new regulation is designed to help you better understand and evaluate your health insurance choices.
The government knows it’s not easy for consumers to know what they are buying when shopping for insurance. The Department of Health and Human Services standardized the law and made the new law easy to understand, so the information about health plan benefits and coverage allows you to more easily make “apples to apples” comparisons among your insurance options. The measure brings more openness to the insurance marketplace for the more than 180 million Americans with private health coverage.

Curbing Insurance Cancellations - Insurance Companies can no longer cancel your coverage just because you made an honest mistake on your application.
Life Time and Annual Limits - The Affordable Care Act prohibits health plans from putting a lifetime dollar limit on most benefits you receive. The law also restricts and phases out the annual dollar limits a health plan can place on most of your benefits — and does away with these limits entirely in 2014. Under the law, lifetime limits on most benefits are prohibited in any health plan or insurance policy issued or renewed on or after September 23, 2010. For more information on limits please click here.
Preventive Care - Under the Affordable Care Act, you and your family may be eligible for some important preventive services — which can help you avoid illness and improve your health — at no additional cost to you.
If your plan is subject to these new requirements, you may not have to pay a copayment, co-insurance, or deductible to receive recommended preventive health services, such as screenings, vaccinations, and counseling. For example, depending on your age, you may have access at no cost to preventive services such as:
· Blood pressure
· Diabetes, and cholesterol tests
· Regular well-baby and well-child visits
· Routine vaccinations, flu and pneumonia shots
· Many more
ER Access & Doctor Choice - The Affordable Care Act helps preserve your choice of doctors by guaranteeing that you can choose the primary care doctor or pediatrician you want from your health plan’s provider network. It guarantees that you can see an OB-GYN doctor without needing a referral from another doctor. The law also ensures that you can seek emergency care at a hospital outside your plan’s network without prior approval from your health plan.
Penalties and Fees - If you choose not to get Health Care Coverage of any kind you will be penalized. The penalty calculation is based on several different factors. Click here for more detail on the penalty calculation. Some think once you pay the penalty that you are automatically enrolled or assigned a Health Care Plan. This is simply not true you will have to select a Health Care plan or risk receiving another penalty. We know this is a lot of information to take in. We hope you have a better understanding of the Affordable Health Care Act. If you need any additional information you can check out Health Care. Gov.
Stay healthy, stay safe and stay insured.
--KH
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Love. Work. Repeat. © 2014 All Rights Reserved
Love. Work. Repeat. © 2014 All Rights Reserved