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--

BREAKING NEWS

HOW THE NEW HEALTH EXCHANGES WORK COME OCTOBER 1ST
And why you're no longer at the mercy of insurance companies

September 22, 2013




Key dates for Affordable Health Care Act. CLICK TO ENLARGE.
(SEATTLE, WA) --- Starting in October the new Health Exchanges kick into gear where people who don't have health insurance can purchase it at affordable cost on the new Health Care exchanges.

It's all part of the Affordable Health Care Act passed by Congress - an act that puts citizens on a level playing field for the first time with the powerful, well funded health insurance industry.

Among other things for the first time health insurers can no longer reject you for coverage or charge you more than someone else because you have a pre-existing health condition or your child has such a condition.

That is now in the past thanks to the Affordable Health Care Act (e.g., Obamacare).

In addition health insurance companies can no longer practice health care rationing against Americans who get very ill, and then find their insurance suddenly cancelled, as was done routinely in a once secret health insurance industry practice called "rescission."

HOW INSURANCE COMPANIES USED TO SECRETLY RATION HEALTH CARE

Insurance executives from three major health insurance companies appeared before Congress in June 2009, admitting that they routinely cancelled medical coverage of seriously ill customers in a practice called “rescission”, that left patients without health coverage and in many cases caused patient suffering, bankruptcy and even death.

And all three said their companies would continue the practice - this was before Obamacare was passed by Congress - despite blistering criticism from lawmakers on both sides of the aisle who decried the rationing practice as both unfair and abusive.

The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills and nowhere else to turn, began a day after President Obama outlined his proposals for revamping the nation's healthcare system.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies in turn to avoid paying more than $300 Million dollars in medical claims over a five-year period.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were actually targeted for rescission (rationing of care) and that employees were, in some cases, praised in performance reviews for terminating the policies of customers with expensive illnesses.

THE NEW HEALTH INSURANCE EXCHANGE MARKETPLACE

In Washington State the insurance-exchange marketplace fires up October 1st as the Washington HealthPlanFinder which is designed as a a one-stop shopping site to hjelp and guide those that need affordable insurance but are not covered by a health plan where they work.

The Seattle Times also has a comprehensive "users guide" to the changes that are coming in October that you'll find here .

At upper right find key dates for Affordable Health Care Act. CLICK TO ENLARGE.


**************************************************************************************************************************************************

BELOW IS A BRIEF SUMMARY
of just a few of the benefits available to all Americans that are contained in
the Affordable Health Care Act.

**************************************************************************************************************************************************


More detailed information about the act and what it does can be found
here

1 Increased coverage of preventive services
Many health insurance plans are now subject to new rules that require them to cover recommended preventive services without charging a co-payment. As a result, consumers pay nothing for services like routine screenings, vaccines, counseling, flu shots and well-baby and well-child visits from birth to age 21.

2 Birth control coverage
One aspect of the preventive care coverage -- and among the most discussed provisions of the new health care law -- is the requirement that health insurance plans cover contraceptive services.

3 Restrictions on lifetime and annual limits
The Affordable Care Act prohibits insurers from placing lifetime limits on most benefits that consumers receive and sets a minimum for annual dollar limits. By 2014 annual dollar limits are slated to be phased out entirely.

4 Coverage for children with pre-existing conditions
Under the new law, insurance companies cannot deny coverage or limit benefits to children under age 19 because of a pre-existing condition or disability. Starting in 2014, people of all ages with pre-existing conditions will be protected.

5 Pre-Existing Condition Insurance Plan
Adults who have been refused insurance coverage because of pre-existing conditions and who have remained uninsured for at least six months are eligible for the Pre-Existing Condition Insurance Plan. The program covers primary and specialty care, prescription drugs and hospital visits without requesting higher premiums for pre-existing conditions.

6 No health plan barriers for ob-gyn services
Health plans cannot require women to get a referral from a primary care doctor before seeking ob-gyn services.

7 Access to out-of-network emergency room services
The Affordable Care Act prohibits a health plan from charging higher co-payments for emergency room visits in hospitals outside of the plan's network. Patients are also exempt from needing a plan's approval before seeking out-of-network emergency care.

8 Right to appeal health insurance plan decisions
The health care law gives consumers the right to appeal decisions made by their health insurance providers. If an insurance company reviews its decision and still denies a consumer insurance coverage for a treatment, consumers have the right to request an external review and have an independent review organization decide whether to overturn the plan's decision. Some states have Consumer Assistance Programs that help people file appeals and request external reviews.

9 Consumer Assistance Program
The Affordable Care Act improves the services that some states provide to help people with insurance problems. Grants have allowed states to strengthen and grow programs that assist consumers with enrolling in a health insurance plan and with filing complaints and appeals.

10 More value for the insurance dollar
A provision of the law called the 80/20 rule requires insurance companies to spend at least 80 percent of their premium dollars on medical care. If they don't, they must provide consumers with refunds.

11 No insurance cancellations for honest mistakes
Insurance companies are not allowed to rescind coverage when patients make honest mistakes on their insurance applications. Before the Affordable Care Act, insurance companies could retroactively cancel patients' policies because of unintentional paperwork errors with little medical bearing.

12 Expanded Medicare coverage
The law gives elderly adults who face the Medicare coverage gap a 50 percent discount on prescription drugs covered by Medicare Part D. Seniors will receive additional prescription drug savings until the coverage gap is closed in 2020.

13 Indian Health Care Improvement Act reauthorized
The law reinstates the Indian Health Care Improvement Act, which provides resources to curb the health care disparities faced by American Indians. Originally passed in 1976, the act was last reauthorized in 1992 and many of its provisions expired in 2000.

14 Tanning salon tax
The Affordable Care Act imposes a 10 percent tax on tanning beds, and these proceeds help underwrite other provisions of the law.

15 Expanded coverage for young adults on their parents’ plans
The law requires insurance plans that offer coverage of dependents to allow children to stay on their parents' plans until age 26. Adult children can be covered on their parents' plans even if they are married, eligible for work or student insurance, living away from home or financially independent.





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