Several important consumer protection features of health reform are set to go into effect Thursday, six months after the federal Affordable Care Act health reform package was signed into law, according to Delegate Donna Christensen.
Also known as the Patient’s Bill of Rights, these provisions seek to end insurance company abuses and put consumers and their doctors back in control of their own care, according to Christensen.
According to Christensen, the bill will “outlaw once and for all the most egregious practices of the insurance industry."
She added that V.I. adults will now be able to stay on their parents’ insurance until their 26th birthday and that "Virgin Islanders will no longer be subject to lifetime caps on what health insurance will pay, or risk losing their coverage when they get sick."
For health plan years beginning on or after Sept. 23, all U.S. citizens who currently have health insurance will have the following protections:
— Health coverage cannot be arbitrarily cancelled if you become sick;
— Children cannot be denied coverage due to a pre-existing condition;
— Children up to age 26 can stay on their parents’ health plan;
— Health insurance giants cannot put a lifetime limit on health coverage;
— Health plans’ annual limits are phased out over three years.
Those, consumers purchasing new plans will have the following new protections:
–Patients have the right to choose their own doctor;
–Preventive services will be available without deductable or co-payments;
–Patients have the right to both an internal and external appeal of insurers’ coverage decisions;
–Health plans must make certain preventive services, like mammograms and colonoscopies, free of charge;
–Patients have the right to access out-of-network emergency room care at in-network cost-sharing rates.
Small businesses can get assistance with providing insurance benefits to their workers, too, Christensen said. The first phase provides credit up to 35 percent of what the business pays for their employees’ health insurance. Small non-profit organizations may receive up to a 25 percent credit.
The new law also creates different ways to reduce fraud in Medicaid, Medicare and CHIP and will improve the overall quality of health care and lower health care costs for thousands of V.I. consumers, Christensen said.
For more information about the Affordable Care Act, please visit www.healthcare.gov.
