I thought the bill
should have gone further,
but it’s still a significant
achievement and I’m glad so
many will be helped.
If you are self-employed or working in a small business, buy-
ing insurance for yourself and your family—or have no insur-
ance at all—you are among those that the new law helps
the most. Millions of Americans currently pay the highest
rates for health coverage because they buy it on their own.
Others—especially those ages 50 to 64—can’t buy coverage
at any price because they have preexisting medical condi-
tions. Making private insurance more accessible and fairer for
consumers is a central goal of the new law.
Little Rock, Ark.
None. He was rejected by five insurance compa-
nies for a “pre-diabetic condition” even though he’s never been
hospitalized and takes only a diuretic that costs $5 a month.
Under new law:
He should be able to get insurance almost
immediately through a temporary high-risk program for
those with preexisting conditions who have been uninsured
for at least six months. He may find that this coverage does
not come cheap, but under the rules he can’t pay more than
$5,950 out of pocket a year. The program starts in July and
runs until 2014, when many new coverage options will be
available through an insurance exchange.
If you have a preexisting condition and have
been uninsured at least six months, you’ll be eligible to buy coverage
through a temporary high-risk program—which limits what you’ll be
charged for out-of-pocket costs—that starts in July and ends when
insurance exchanges (see page 24) become available in 2014.
Immediate coverage protections:
Insurers can no longer drop
your coverage if you’ve paid your premiums. Health plans can’t limit
what they will spend on your care during your lifetime. Starting in
2014, they can’t place limits on your annual health costs either. Plans
must justify steep price hikes.
Starting in September, children cannot
be denied coverage because of a preexisting condition. Adults receive
the same protection in 2014.
Coverage for adult children:
If your company offers a family cover-
age plan, unmarried children can be covered under your policy until
they reach age 26. This change begins in the fall, but you should con-
sult your insurer to find out which month it takes effect for your plan.
Health plan choices:
Starting in 2014, you can select a private
health plan from a menu of choices offered through an insurance
exchange run by your state. And your yearly out-of-pocket expenses
will be limited.
Enrollment and premium protections:
Health plans cannot deny
you coverage or make you pay more for your insurance because of
your health, past medical problems or gender, starting in 2014. But
they can raise premiums by up to 50 percent for people who smoke.
Free preventive care:
Health plans you buy on your own must
cover certain preventive services, screenings and vaccinations free
of charge. This requirement starts as soon as your current plan’s next
coverage year begins or when you join a new plan.
Starting in 2014, insurers can charge older people
no more than three times the amount they charge younger adults.
Currently, insurers can charge older people up to 10 times what they
charge younger people.
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