Healthcare Reform – How it may Affect You

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Read Here About Healthcare Reform!

Healthcare Reform has been signed into law and whether you are in favor or not, there is no reason to be overly exuberant today. While much of the law will be left to interpretation by the Secretary of Health & Human Services (HHS) some Healthcare changes start in 2010.

Some of what will happen in 2010: State grants to establish or expand ombudsman programs are awarded. Illinois Programs like Senior Health insurance Program (SHIP) and Uninsured Ombudsman Program (such as AllKids) will receive more federal funds.

A new federal rate review process is established. This may be very interesting. Insurance companies go to the state departments of insurance if they need a rate increase. The information they present is actuarial and not opinion. On a related note: Last month, Massachusetts Governor Patrick denied 235 of 274 increases proposed by insurers. It will be interesting whether the insurance companies in Mass. are able to offer the same plans at lower rates, apply for approval of new plans and rates, or if the insurance companies will pull those products out of Massachusetts.

A National high risk pool is to be created 90 days from enactment. This will be similar to the state program in Illinois named ICHIP (Comprehensive Health Insurance Program). This program is still available for those with medical conditions who are trying to buy insurance.

A small business tax credit is established. Businesses with fewer than 50 employees should realize tax credits in 2010.

On October 1, 2010 lifetime benefit limits will be prohibited. Rescissions (policy less than two years old is cancelled as if it was never in force due to information not revealed upon application) will also be prohibited except if the company can prove fraud or material misrepresentation. Dependent coverage up to age 26 is mandated. Pre-existing exclusions for dependents are prohibited. Allows restricted annual limits for essential benefits as determined by HHS.

Some of the immediate impact expected from Healthcare Reform will be: health insurance companies will develop new plans and file for new rates with their state departments of insurance. The states will approve or disapprove these filings. These rates will also, most likely, be reviewed by the new HHS agency.

So, what will this mean to you? First, in most cases plans can still refuse to cover an individual now (in 2014 guaranteed issue is established). If you have tried to cover your dependents in the past and they were refused issue, you should contact your insurance company again now and then again after 10/1/10 to see if they can be added now. Be prepared for premium increases based on the mandates of coverage imposed by the Healthcare Reform Law. Mostly, in 2010 handle your health insurance program as you always have. Gather information relevant to your situation especially now, on 10/1/10 and each January 1st through 2018.

This law is very complicated. Much of it would be enacted as interpreted by the Secretary of HHS. To be certain, this law will be tweaked the next few years. Midterm elections and the makeup of the US governing bodies will have an impact on the provisions of Healthcare Reform. Stay involved or become involved in that process if you have thoughts on this subject.

Most professional insurance agents have been attending seminars in an attempt to understand the implications of Healthcare Reform to best help you. Use them as a resource. Also, you can use as resources: www.ahip.org (America’s Health Insurance Plans) and our website at www.MRMS-INC.com for a timeline and description of the Healthcare Reform law, or contact our office at 309-693-1060.

Written by

Steven A. Buttice is the president of Medical Reimbursement & Management Services, Inc., a firm specializing in issues affecting seniors, including seminars and consultation on Medicare Plans, Long Term Care and other types of insurance, claims issues, and sales/service of insurance products since 1984.

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