Affordable Care Act & Grandfathered Health Plans

Healthreform.gov published an article on Affordable Care Act and "Grandfathered" Health Plans. The purpose of the Affordable Care Act is to give families and businesses more control over their health care

Protecting Patients' Rights in All Plans

• Must provide certain benefits to their customers for plan years starting on or after September 23, 2010.

Additional Consumer Protections Apply to Non-Grandfathered Plans

• They can make routine changes
• Grandfathered plans for policies in effect on March 23, 2010
• Cannot:
• cut or reduce benefits
• raise co-insurances
• significantly raise co-payment charges
• significantly raise deductibles
• significantly lower employee contributions
• add or tighten on annual limit on what insurer pays
• change insurance companies

Projected Impact on Consumers and Plans

• Large Employer Plans
• Small Business Plans
• Individual Health Market
• People in Special Types of Health Plans

Projections of Employer Plans Remaining Grandfathered, 2011-2013

• See chart in article
• Choices in 2014 and subsequent years

For the full article, please click the following link: Keeping the Health Plan You Have: The Affordable Care Act and Grandfathered Health Plans

For additional billing, coding and reimbursement resources, please click the following link: Medical Reimbursement Resources Page

Health Care Exchanges Under the Affordable Care Act

The New York Daily News published an article on the future of health insurance and what you can expect from health care exchanges.  These changes will start in fall of 2013. Some key takeaways from the article are listed in the bullets below:

• The goal is quality coverage for millions of Americans who do not have health insurance.
• Individuals and Families will have a choice of private health plans 
• The government will help many middle class households pay their premiums
• Open enrollment will start on October 1st, 2013. Enrollment will be online, storefront operations as well as help at call centers.
• Coverage will take place on January 1, 2014 and everyone will be required by law to have health insurance.
• There will be penalties for some individuals:
• For example, as cited in the article: smokers will face a financial penalty and younger "well-to-do" people may not be eligible for income-based assistance.
• There is some concern that the people who need (and will benefit) from the help the most are unaware that these changes are coming and won't benefit when it is first available.

For the full article, please click the following link: The Future of Health Insurance: What to Expect From Health Care Exchanges Under the Affordable Care Act

For additional billing and coding resources, please click here: Medical Reimbursement Billing and Coding Resources.