First Wave of Insurance Reforms To Go Into Effect
Sept. 23, 2010
Today, the first set of consumer protections for health insurance included in the Patient Protection and Affordable Care Act (federal health care reform) will go into effect. These protections include:
* Prohibiting denials or limits on coverage or benefits for children under age 19 who have a pre-existing condition. This will benefit children living with mental illness who are covered by their parent's plan.
* Prohibiting lifetime dollar limits on most health insurance benefits, including mental health benefits, in all policies issued or renewed after Sept. 23, 2010. This will help protect enrollees, particularly those who experience multiple hospitalizations or have chronic and intensive mental health care needs.
* Extending dependent coverage for adult children up to age 26 in all individual and group health insurance policies. This will make it possible for young adults--at a time when many first experience mental illness--to be covered under a parent's plan.
* Bans on cancelling ("rescinding") insurance coverage due to honest mistakes or omissions in insurance applications. Insurance companies will have to prove fraud to justify cancelling insurance policies.
* New rights to appeal adverse insurance decisions, such as denials of care. For most plans, plan holders must be provided a copy of the rationale for any denial of coverage and, importantly, there will now be an independent external appeals process in all states and for most plans.
Additionally, many plans will now offer certain preventive services, dependent on age, with no cost-sharing or deductible. For example, individuals will now be covered for blood pressure, diabetes and cholesterol tests.
To find out more about these and other insurance reforms going into effect today, visitwww.healthcare.gov<http://capwiz.com/nami/utr/1/BUKWNFKIZG/EKUZNFMRLS/5824027916> .
The federal health reform law contains many other provisions that will make an impact on health and mental health care. These changes will be implemented over the course of the next few years. For a list and timetable of these changes, go to healthreform.kff.org <http://capwiz.com/nami/utr/1/BUKWNFKIZG/JGEUNFMRLT/5824027916>
A series of federal rules have been issued on topics such as preventive services in health care reform, procedures for appealing denials of services and other important topics. To see NAMI's comments on these rules and for more information about how health care reform will impact individuals living with mental illness, visit NAMI's special website on health care reform,www.nami.org/healthcare<http://capwiz.com/nami/utr/1/BUKWNFKIZG/GPNCNFMRLU/5824027916> .