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As we enter in 2011 more aspects of health care reform will have a direct impact on you.
All wellness and preventive care is now covered at 100% with not cost to the customer. So there is no reason not to get your yearly check up. Technically speaking if you have diagnostic services done for wellness you would not pay anything.
Guaranteed issue for children under 19 year of age:
This means a carrier can not deny a child coverage. Now we have a huge problem with aspect of reform because all of the carriers have pulled out of the stand alone child policy market. The other issue is the rate up that the carrier can charg for the child. We are seeing about 400% increase in premium for the child.
Medical Loss Ratio.
This states that at least 80% of your premium has to go to claims or you get a refund. This sounds like a great thing but in the long run it could prevent carriers from entering certain markets. The market where we could see carriers pull out of is Individual.
Individual Maternity Plans are no longer available
Health carriers have pulled out of these markets because of the negative impact of health care reform. It still is not 100% clear but I think if the carriers were to stay in the market the plan could not have a waiting period for the maternity benefit to kick in. In the past a policy had either a 1 year or 9 month waiting period.
Health insurance premium increases
The health care reform does nothing to reduce the premium increases. The premium increases are a direct response to the cost of care. The Reform does put in place a process of review if a carriers want to increase premiums more than 10%. It is important to have these checks and balances in place so everyone sees the process.
Health Savings Accounts
For 2011 the contribution levels will stay the same for a H.S.A custodial account. (Single $3,050, Family $6,150) For members over 55 years of age there is an additional catch contribution of $1,000. Over the Counter medicines are no longer qualified to use HSA accounts to pay for.
Waivers for Health Care Reform
There are a lot of waivers for health care reform because the reform would result in people losing coverage. There should be many states that ask for waivers in 2011.
These are just some aspects of health care reform that will impact you.
There are going to be positive things but we fear the negative could destroy certain markets.
