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Frequently Asked Questions on Healthcare

Q. Since the law went into effect, what is required of insurance plans?

A. Insurance plans must now keep you covered when you get sick. Simple mistakes or typos will no longer be grounds for insurance companies to cancel your insurance.

Insurance plans must also cover children with pre-existing conditions. Your kids can no longer be denied health coverage just because they have a pre-existing condition like hay fever, asthma, or previous sports injuries. This protection extends to all plans, except “grandfathered” plans in the individual market.

Since the law went into effect, young adults are allowed to stay on their parents' plan up to age 26. Even if their first few jobs don’t provide health benefits, your kids can still remain covered by your insurance. The law also removes lifetime limits. You will no longer need to worry about your health insurer limiting the amount of coverage available through their plan if you face an expensive medical condition.

Lastly, the law phases out annual limits. Many plans include annual dollar limits on how much medical coverage can be obtained per year. On all non-“grandfathered” plans in the individual market, these limits will be phased out over the next three years.

Q. What about new insurance plans?

A. New insurance plans must pay for preventive care like mammograms and immunizations. Addressing problems before they start can help keep you healthier, and new insurance plans will now cover many preventative tests and immunizations without any copayment.

The law also gives Americans a better appeals process for insurance claims. Now you’ll have a guaranteed and fair path to help you receive the benefits you paid for if insurance companies deny your claim.

You can now also choose your own doctor. Health reform makes it clear that you can choose any available participating primary care provider as your provider, and any available participating pediatrician to be your child’s primary care provider.

The law also provides easier access to OB-GYN services. Women will no longer be required to have a referral from a primary care provider before seeking coverage for obstetrical or gynecological (OB-GYN) care from a participating OB-GYN specialist.

Now you can also use the nearest emergency room without penalty. If an emergency arises while you’re away, you will no longer have to drive home to your in-network provider to receive in-network benefits.