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Preventative Coverage under new law
Old 04-07-2010, 05:25 PM   #1
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Preventative Coverage under new law

Does anyone have a clue what the following really means or how to get more details in terms of what current insurers must cover for preventative services under the new law?

In 2010, new law:

Requires qualified health plans to provide, at a minimum, coverage without cost sharing for preventive services rated A or B by the U.S. Preventive Services Task Force, recommended immunizations, preventive care for infants, children and adolescents and additional preventive care.

Reason I ask is that my current retiree plan does not cover any preventative such as annual physicals, mammograms, colonoscopy, etc.

I have to pay for the above 100% and they will not even help get discounts and my costs do not count against the $2000 deductable.

Does the new law require them to now? I want to fight them on this but need some amunition first.

Thanks for the help.
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Old 04-07-2010, 06:52 PM   #2
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Old plans don't have to comply with that until 2014, new plans created after the Health Care Reform became law must immediately comply with it. Congress wants to give the insurance industry time to structure their pricing, it would be a huge mess to immediately require most preventative care be "free" (it is not free) under an old pricing scheme. Prices will be reasonable though for seniors, the self-insured young, who won't qualify for many preventative procedures due to age, will be over a barrel on pricing.
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Old 04-07-2010, 10:42 PM   #3
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Thanks. This is why the entire bill will be very confusing to everyone.

If you read the link below, it implies preventative care will be required by all plans in 2010 not just new plans. There is nothing in this summary that implies new plans only. Why would an insurance company even bother with new plans anyway under more strict laws? There is no advantage to them

Health Care Overhaul: What Happens When - Kiplinger
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Old 04-08-2010, 04:01 AM   #4
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Oh, there is an advantage, the insurance company will just price in the preventative care and no new really cheap non-preventative care plans will exist. The insurance companies will definitely get their $$$.

Also, did some more looking, Kaiser says this:

"Require qualified health plans to provide at a minimum coverage without cost-sharing for preventive
services rated A or B by the U.S. Preventive Services Task Force, recommended immunizations,
preventive care for infants, children, and adolescents, and additional preventive care and screenings for
women. (Effective six months following enactment)"

Not sure what a "qualified health plan" refers to, it could refer to new plans, or preexisting ones that meet certain criteria.
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Old 04-08-2010, 06:29 PM   #5
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Yeah everyone is right, even or when companies are forced to include preventative care or no limits on benefits, the premiums will skyrocked for the middle class.

I hope you are right that is not forced until 2014, when there will be other choices for RE, as if it is forced now, my company will most likely eliminate all other options except the one they offer now with preventative care, that costs $1000, yes $1000, more per month for the two of us.

If it comes to that only choice will be to go naked for 6 months and try to get that government minumum coverage if that is even possible or affordable. Can only imagine how expensive it will be.
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