Here are provisions of the federal Affordable Care Act that take effect Thursday:
Prohibiting denying coverage of children based on pre-existing conditions
Insurance companies will be prohibited from denying coverage to children under the age of 19 due to a pre-existing condition. Effective for health plan years beginning on or after Sept. 23 for new plans and existing group plans.
Prohibiting insurance companies from rescinding coverage
In the past, insurance companies could search for an error or other technical mistake on a customer’s application and use this error to deny payment for services when he or she got sick. After media reports cited incidents of breast cancer patients losing coverage, insurance companies agreed to end this practice immediately. Effective for health plan years beginning on or after Sept. 23.
Eliminating lifetime limits on insurance coverage
Under the new law, insurance companies will be prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays. Effective for health plan years beginning on or after Sept. 23.
Regulating annual limits on insurance coverage
Insurance companies’ use of annual dollar limits on the amount of insurance coverage a patient may receive will be restricted for new plans in the individual market and all group plans. In 2014, the use of annual dollar limits on essential benefits like hospital stays will be banned for new plans in the individual market and all group plans. Effective for health plan years beginning on or after Sept. 23.
Appealing insurance company decisions
The law provides consumers with a way to appeal coverage determinations or claims to their insurance company, and establishes an external review process. Effective for new plans beginning on or after Sept. 23.
Extending coverage
for young adults
Young adults will be allowed to stay on their parents’ plan until they turn 26 years old (in the case of existing group health plans, this right does not apply if the young adult is offered insurance at work). While the provision takes effect Sept. 23, many insurance companies have already implemented this new practice.
Source: U.S. Department of Health and Human Services
