How to know if you benefit from the new health care law

The Patient Protection and Affordable Care Act, or PPACA, became law in March 2010, and some of the provisions have already taken effect. Millions of Americans will be impacted by the law now and also in 2014, when the majority of the changes take effect. Many major changes in the health care system went into effect in 2010.

Instructions

Add Dependent Coverage

• 1

  Check whether your employer-based insurance allows dependent coverage. If so, you may request that your child be added to your plan. Dependents now may be covered up to age 26, whether they live at home, are in school or working, are married or living on their own.

• 2

  Check to see if there are any exclusions or limitations to the dependent rule. If your child is employed and his employer offers health coverage, the child will not be eligible for coverage as your dependent. If the child is employed, but the employer does not offer coverage or the employee is not eligible for coverage because they only work part time, then the child may be added as a dependent up to age 26.

• 3

  Add dependent coverage, if needed, after determining costs of extending dependent coverage. Most insurers will charge the employee a premium for adding dependents to health coverage. Dependents may typically only be added during the employer's open enrollment period. Check with your human resources office or benefits manager to determine your employer's specific requirements.

Pre-existing Medical Conditions

• 4

  Check with your state Health and Human Services agency to determine whether your state has established a high-risk pool for uninsurable individuals. PPACA made federal money available for states to cover people who are uninsured because they were denied coverage due to a pre-existing condition. Most states now have set up high-risk pools to allow these individuals to buy health insurance as a group with guaranteed coverage.

• 5

  Also, check the state website to determine eligibility for the high-risk pool. You must show proof that you applied for and were denied coverage due to a pre-existing medical condition in order to qualify.

• 6

  Check the state website to sign up for the high-risk pool. The website has information about plan options and premium costs. Coverage through the high-risk pool will be effective until January 2014, at which point individuals will be eligible to purchase coverage through newly created state health insurance exchanges.

• 7

  Check with your employer and your state Health and Human Services agency about insuring a child that has previously been denied coverage due to a pre-existing medical condition. Individual insurance plans issued after March 23, 2010, cannot deny insurance or deny coverage for certain services to children based on pre-existing conditions. PPACA bans employment-based insurance plans from denying insurance or denying coverage for services for children who have pre-existing conditions. The ban will extend to adults on January 1, 2014.

Early Retiree "Re-insurance Program"

• 8

  Check with the federal Health and Human Services Agency about the early retiree "reinsurance program." The health care law allows retired people between the ages of 55 to 64 to buy back into the health insurance pool until they become eligible for Medicare.

• 9

  Check the Early Retiree Re-insurance Program website to determine whether your ex-employer participates in this program. PPACA provides reimbursement to certain employer-based or union-based insurance plans to extend coverage to early retirees, their spouses and their dependents.

• 10

  Check with your ex-employer's human resources representative to determine your eligibility and that of your dependents.

Co-pays

• 11

  Check with your human resources department about your employer's specific health plan contract. As of September 23, 2010, insurers are no longer allowed to charge patients any co-pays or deductibles for preventive care. Some existing plans are excluded from this rule.

• 12

  Check the list of preventive services that are eligible. The U.S. Preventive Services Task Force, or USPSTF, issues a list of the preventive services recommended based on age and gender. Any service on the list with a Grade A or B recommendation is included on the list of no-cost preventive care. The USPSTF updates recommendations continually.

• 13

  Check the list of immunizations that are now covered cost-free to patients. All immunizations recommended by the Advisory Committee on Immunization Practice, or ACIP, are to be provided at no cost. The ACIP updates recommendations continually.