TRAVERSE CITY — Just 10 days remain until the uninsured and underinsured can buy affordable health care coverage, and questions about the Patient Protection and Affordable Care Act — also known as the Affordable Care Act, “Obamacare,” Health Care Reform and “the new health care law” — still loom large. Here are some questions posed to experts at a Thursday night forum and the answers they gave.
Q. What changes have already occurred as a result of the law?
A. Changes that applied to most health coverage starting on or after Sept. 23, 2010 include an end to lifetime limits on care, addition of no-cost preventive care and protection from being dropped by insurance companies because of making a mistake on an application. Changes also include extended coverage for young adults (to age 26) on their parents’ plan and an end to coverage denial because of pre-existing conditions for those younger than 19.
Seniors who are in the Medicare prescription drug coverage gap known as the “donut hole” will receive discounts of up to 50 percent on covered prescription drugs. Seniors also will be entitled to a “Welcome to Medicare” preventive visit and yearly wellness visits (not annual physicals) thereafter. Medicare recipients will continue to get coverage through Medicare, with no reduction in benefits.
In addition, small business owners will be eligible for tax credits if they buy coverage for their employees.
Consumers can file a complaint or appeal with their health carrier if it refuses to provide health care coverage, reduces benefits or denies health benefit claims. Once they exhaust the health carrrier’s internal grievance process, consumers can request an external review with the Michigan Department of Insurance and Financial Services.
Q. What can consumers expect in 2014?
A. Consumers who are uninsured, purchase individual coverage or believe their employer-provided coverage is inadequate or unaffordable, will be able to shop for coverage directly in the federal Health Insurance Marketplace, accessed through HealthCare.gov, a new insurance marketplace for individuals and small businesses to shop for health coverage.