Know Your Patient's Bill of Rights when Signing Up for Medical Insurance

http://edlabor.house.gov/blog/2010/09/a


On March 30, 2010 President Barack Obama signed the Affordable Care Act which came into effect on September 23, 2010.  This historic law affords insured patients important protections which put more control of  medical insurance coverage  in their hands.  This is known as the Patient's Bill of Rights.


Patient's Bill of Rights:

• Children can no longer be denied coverage because of pre-existing medical condition.  Previously, children born with or who develop costly medical illness could be denied coverage.The law now prohibits this and by 2014, all Americans will have this protection as well. The White House expects 72,000 uninsured children will benefit from this law.

• Insurance companies can no longer retroactively drop coverage for a sick insured member because he made an unintentional mistake in his application (unless fraud can be proven.) This has affected some 10,700 patients each year whose medical insurance coverage were dropped at a time when they most needed it.

• The lifetime cap of medical usage and benefits has been lifted.  Often patients max out on their lifetime benefit because of illness and are left to pay medical bills on their own.  The law affords this protection.The annual benefit limit will gradually be phased out and will be totally lifted by 2014..

• Patients may now choose their own physicians within their network. Women may choose their obstetrician and parents can choose the pediatrician for their child without first obtaining a referral from their primary care doctor.

• Parents may choose to keep their adult children in their health insurance plan until age 26, unless the child is employed and eligible to participate in his employer's medical insurance plan.

• In emergency conditions, patients may now use the closest emergency room even if it is out of network. Insurance plans are obligated to pay in network rates whereas in the past, the patient was penalized by having to pay higher cost sharing co-insurance for going to out of network emergency rooms.

• Patients now have the right to both an internal (within the insurance company) and an external (independent third party) appeal when the medical insurance plan denies a service.  In the past,patients could only go through the internal appeals process.

• Patients may now receive preventive services without having to pay deductibles, co-insurance and co-pay.  These services include mammograms, colonoscopies, prenatal care, immunizations and well baby care. Many Americans missed out on necessary preventive care due to the added expense.

 
Watch for more on the Affordable Care Act in this blog.