One year ago today the Affordable Care Act (ACA) was signed into law. The Patient’s Bill of Rights is a set of ten provisions in the law that aims to correct the abuses and limitations of the health insurance industry.
Patient’s Bill of Rights:
1. Reviewing insurers’ premium increases
2. Getting the most from your premium dollars by limiting spending on non-clinical care
3. Keeping young adults covered until age 26
4. Providing affordable coverage to Americans without insurance due to pre-existing conditions
5. No pre-existing condition exclusions for children under age 19
6. No arbitrary rescissions of insurance coverage
7. No lifetime limits on coverage
8. Phasing out annual dollar limits on coverage
9. Protecting your choice of doctors
10. Removing insurance company barriers to emergency department services
All these rights are meant to improve your ability to get the care you need. One of the most heralded of these rights is the ability to get health insurance even if you have pre-existing conditions. For those with chronic diseases, from relatively minor conditions like acne to more debilitating diseases like lupus, getting coverage in the individual insurance market was next to impossible. Now, there are Pre-existing Condition Insurance Plans that will cover anybody who wasn’t able to get insurance due to a pre-existing condition. These plans will be in place until 2014 when all insurers will be required to cover any adult irrespective of pre-existing conditions.
Two other provisions worthy of mention are the lifting of lifetime limits on coverage and the phasing out of annual limits on coverage. People with severe chronic diseases can go through expensive therapy and see improvement in their lives only to find out that their plan will not cover any further treatments because of caps. The Fatula family in Pittsburgh have four sons, three of whom have hemophilia. The clotting factors they use are expensive and all three have exceeded their lifetime cap of $1 million. The boys were switched to Medicaid once they reached their lifetime caps. When the oldest turned 18 he wasn’t certain as to how he would get coverage since he would no longer qualify for Medicaid. Under the ACA this will no longer be a problem.
The Patient Bill of Rights is just one part of the ACA but it contains the provisions that are already in place and helping folks get the care they need. It really is a cause for celebration.
Image courtesy Peter Lindberg