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What changes are already in place?


Several changes are already in place:

  • Lifetime dollar limits on essential health benefits aren't allowed. Annual dollar limits on essential health benefits are being phased out by January 1, 2014.
  • The appeal procedures available to consumers are different.
  • Insurers can't deny coverage to children younger than 19 years old because of a pre-existing condition.
  • Nearly all adult children up to age 26 are eligible to remain on a parent's health insurance policy, regardless of the child's marital status, financial dependency, enrollment in school, or place of residence.
  • In-network and participating providers must cover preventive services. There can be no cost-sharing for preventative services. (See question: Can a person's health condition affect their coverage?)
  • Consumers have more access to information about proposed rate changes.
  • Medical loss ratio standards limit how much of premium dollars insurers can spend on administrative expenses.
  • All insurers must use a standardized Summary of Benefits and Coverage (SBC), which will make it easier to compare plans.
  • Small employers that provide health care for employees can apply for a tax credit. Persons with Medicare prescription drug coverage receive a rebate to help cover the cost of the "donut hole." This "donut hole" should be totally phased out by 2020.
  • Persons with Medicare prescription drug coverage receive a rebate to help cover the cost of the "donut hole." This "donut hole" should be totally phased out by 2020.
  • ACA made subsidized coverage available in every state for people with pre-existing conditions who can't find coverage in the private market. However, because there's not enough money, no new enrollments in this program are being accepted.

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