Patient Protection and Affordable Care Act Changes Begin Today

It’s been six months since passage of the administration’s healthcare reform act — the Patient Protection and Affordability Care Act (PPACA).   As reported in newspapers around the country, that means that for those health plans that begin today: 

  • Parents will be able to keep their young adult children on their group health plan up to age 26, regardless of whether the adult child lives with the parent, is a full-time student, disabled or married.
  • Insurance companies will be banned from dropping coverage when an enrollee gets sick.
  • All new plans must offer free preventive services, such as mammograms, colonoscopies and certain child preventive health-care services, meaning plans can’t charge deductibles, co-pays or co-insurance.
  • All employer plans and new plans in the individual market will be prohibited from denying coverage to children under age 19 with pre-existing conditions.
  • Parents will be able to select a pediatrician as the primary care provider for their children.
  • Female enrollees will be able to obtain obstetrical/gynecological specialist services without a referral from another primary care provider.
  • Group plans will be banned from imposing lifetime benefit limits and will start gradually eliminating annual benefit limits.
  • New plans must provide consumers access to an internal and external claims appeals process.

For plans operating on the calendar year, these new PPACA requirements will take effect on January 1, 2011.