Health Care Reform Fine Print: 4 Big Ways It Affects You

Amy Kuras
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pelosi health careNow that many provisions of the controversial health care reform law have gone live, we actually get to see what, if any, effect this law has on our personal health.

The biggest impact could be that you no longer will have to pay a co-pay, co-insurance, or any other cost sharing for preventive care services like cancer and cholesterol screenings, diabetes testing, and counseling from your doctor about treating depression or losing weight.

The idea is that catching and treating things like cancer and heart disease early can prevent more expensive care from being necessary down the road, and that more people might actually access these services if they don't need to cough up a sometimes-hefty co-pay for them.

This being the government, of course there is fine print.

1. The Grandfather Clause

If your health plan existed and hasn't changed significantly since the law was passed on March 23, you're out of luck -- "grandfathered" plans don't have to comply. Most people who already have health care would be covered under one of these plans, I'd suspect.

2. ER Rules

Another big change is that you can use the nearest emergency room, instead of having to use one within your plan's network, and still have the visit covered. Personally, I bypass the nearest (urban-hellish) emergency room to go to a nice cushy one in the suburbs that's in my doctor's network, but if you don't live in an urban area with several hospital choices, this could be a big relief.

3. Lifetime Limits

If you're sick or just have a costly chronic condition, your insurance plan is no longer able to impose a lifetime limit on your coverage. If you have already hit your limit and lost your coverage, you must be reinstated January 1 or whenever your new plan year starts.

4. Children

And while this applies to your kids and not to you, it certainly could reduce your stress: Children with pre-existing conditions can no longer be denied coverage. I've got a kid with a chronic condition, and luckily my husband, who carries the health care, likes his job and it's relatively secure. Until now, if we'd had to get new coverage for him, we'd be out of luck.

Many of these provisions don't actually kick in until your health plan renews (January 1 for most of us), but if you're beginning a new health plan now if you just got a new job, for example, they go into effect today.

How do you feel about the new health care law?

 

Image via Speaker Pelosi/Flickr


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