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Preventative Care Mandate and New Law
Old 03-24-2010, 04:56 PM   #1
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Preventative Care Mandate and New Law

What is the exact mandate that preventative care must be included at no cost this year by health plans.

Reason I ask is the President Obama's quote from yesterday did not explain what preventative care would cover, ie annual exams, mamograms, colonoscopies, etc. There is nothing out there that details that. so it seems open to interpretation by insurance companies.

Also he stated it applied to NEW plans, implying current plans are grandfathered and will not have to provide them.

Anyone got information to frame this better?

Thanks
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Old 03-24-2010, 05:04 PM   #2
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Old plans also have to eventually conform as well, the insurance companies have a fair amount of time to make these changes though (and adjust their premiums). I believe it was that old plans had to include "preventative" care by 2014. Since preventative care under private plans usually meant checkups, I think this will mean something like at least one annual checkup being included in every plan, but that is just a pure guess, we should be able to get an idea (from the new plans that form) of what exactly will actually happen.
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Old 03-24-2010, 06:55 PM   #3
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Originally Posted by oliverdickens View Post
What is the exact mandate that preventative care must be included at no cost this year by health plans.

Reason I ask is the President Obama's quote from yesterday did not explain what preventative care would cover, ie annual exams, mamograms, colonoscopies, etc. There is nothing out there that details that. so it seems open to interpretation by insurance companies.

Also he stated it applied to NEW plans, implying current plans are grandfathered and will not have to provide them.

Anyone got information to frame this better?

Thanks
I really like the idea that some non-free good can be made free by a governmental mandate. I want Pres O to mandate free non diseased young prostitutes for anyone without a weekend date or a satisfactory mate. Then I would like a mandate to provide anyone with all the fresh halibut he or she can eat, then perhaps dry-aged filet mignon every Saturday.

Isn't government grand?

Ha
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Old 03-24-2010, 06:59 PM   #4
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I really like the idea that some non-free good can be made free by a governmental mandate.
Nobody said anything about "free". The requirement is that new insurance policies have to include preventive care . I'm sure they will charge for it.
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Old 03-24-2010, 07:22 PM   #5
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Nobody said anything about "free". The requirement is that new insurance policies have to include preventive care . I'm sure they will charge for it.
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Originally Posted by oliverdickens
What is the exact mandate that preventative care must be included at no cost this year by health plans.
Oh shoot! Here I thought that no cost meant free. Silly me.

Ha
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Old 03-24-2010, 07:47 PM   #6
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Oh shoot! Here I thought that no cost meant free. Silly me.

Ha
Just because someone posts it on a message board doesn't make it so. The text of the law prohibits "cost sharing" for preventive care, which means co-insurance. It doesn't restrict the insurer from increasing the premium.
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Old 03-24-2010, 07:51 PM   #7
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What is the exact mandate that preventative care must be included at no cost this year by health plans.
It includes whatever this means . . .

Quote:
(1) evidence-based items or services that have in effect
a rating of A or B in the current recommendations of the
United States Preventive Services Task Force;
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Old 03-25-2010, 01:35 AM   #8
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I was only quoting what the President said. I agree it means preventative care will be mandated to cost nothing for the service BUT nothing in the law prevents insurers from increasing premiums to cover that mandate.

This is going to be the problem as the President and others throw out general statements and the devil in the details comes out years later when people see premiums rise to cover all mandates, no limits on care, new fees, etc

As some have said on this forum, there are always consequences and it will just take years to see them with these new laws and regulations.
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Old 03-25-2010, 05:15 AM   #9
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Nothing is free.

The only free ride on HC are those below poverty level. Everyone else will pay something.

Regarding preventative care: Once area of focus to try to reduce cost is to make preventive care easier and try to reduce the very expensive cost of chronic illness complications (if problems are ignored).


You can also expect unhealthy lifestyle consumer items to be taxed more heavily... those that are the culprit of obesity and cancer/heart (tobacco and alcohol).
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Old 03-25-2010, 09:38 AM   #10
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Regarding preventative care: Once area of focus to try to reduce cost is to make preventive care easier and try to reduce the very expensive cost of chronic illness complications (if problems are ignored).

That is the idea. One of the potential flaws of "self directed" health care (i.e. pay your own way) is that people try to save money by scrimping on relatively inexpensive care, only to have more complicated and expensive problems develop later. It's kind of like saying "I'm going to save money by never changing the oil in my car."

But nobody knows whether mandating preventive care coverage will end up saving money or costing money. It's one of the many things included in legislation that could save money, but nobody knows whether it will. I'm glad to see at least that the stuff they are covering is "evidence based". That notion got plenty of unjustified heat during the larger health care debate. But its good to see that common sense won out, at least in this small instance.
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Old 03-25-2010, 01:59 PM   #11
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Our plan already provides preventative care coverage with no copay etc.

The problem is MD claims there is no code for preventative care. insurance co says they will not tell us the codes.

The problem comes up that the insurance co says it was diagnotic if they find something. Preventative must not find anything to be preventative.
We just love the back and forth.

My routine bloodtests at one lab was about $300 and covered. DW had blood work at major clinic for $1800. Parts were diagnostic and parts were preventative. Clinic will resubmit bill...ARGH!!!
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Old 03-25-2010, 02:36 PM   #12
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I'm glad to see at least that the stuff they are covering is "evidence based". That notion got plenty of unjustified heat during the larger health care debate. But its good to see that common sense won out, at least in this small instance.

But wait, there's more . . .


Health Law Surprise Is Page 1,617 Demanding Which Drugs Work


Quote:
The overhaul creates an institute, funded with $500 million or more annually, to spur studies of which drugs, devices and medical procedures work best. The boost for comparative- effectiveness research, as the field is known among health experts, will increase scrutiny on treatments used by millions of Americans
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