According to Kaiser Health News, there are several lesser-known provisions of health reform that take effect in the following months.
These provisions include eliminating patients’ co-payments for certain preventive services such as mammograms, giving the government more power to review health insurers’ premium increases and allowing states to expand Medicaid coverage to low-income adults without children.
Insurers won’t be able to charge co-payments or deductibles for certain preventive services such as breast cancer screenings every one to two years, cholesterol blood tests and some sexually transmitted disease screenings. Insurers will also have to cover recommended immunizations at no cost to patients. The change takes effect Sept. 23. Check with your health plan.
A new program will help employers handle the cost of health care for retirees age 55 and older who are not eligible for Medicare. The reimbursements will cover 80 percent of medical claims between $15,000 and $90,000 for retirees, their spouses and dependents. Applications are now being accepted to help cover claims dating back to June 1. Check with your employer or former employer.
Insurers must justify premium increases to the federal government and state insurance commissioners. If premium hikes are deemed to be unreasonable ÛÒ federal regulators have yet to define what “unreasonable” means ÛÒ states could exclude insurers from offering their coverage on health insurance exchanges beginning in 2014.
In 2014, Medicaid will expand to include everyone who makes less than 133 percent of the poverty line ($14,400 this year for individuals). But in the meantime, under the law, states can expand their Medicaid programs to cover these people, and get federal aid to do so.
Approximately 8.8 million “dual eligibles” — individuals who qualify for both Medicare and Medicaid, many of whom are poor elderly — could benefit from a new federal office designed to coordinate their medical care.