Six months ago, the nation’s health care reform bill was signed into law by President Barack Obama. Several provisions outlined in the law went into effect on September 23, 2010 in California and the rest of the country. In this state, many of the new laws are comparable to or even exactly the same as the federal reform. A few examples include the mandates for maternity care, provided coverage for dependents until they reach the age of 26, and mandated coverage for people with pre-existing conditions. The question, then, is why are matching California medical insurance laws needed if they simply mimic the laws on the federal level?
According to Anthony Wright of Health Access California, health care regulations are generally mandated by each state in which a health insurance holder lives. Obama’s new regulations have been the first of its kind on a federal level, forcing California medical insurance laws to conform to the new federal mandates to reduce bureaucratic confusion and remove loopholes in the legal system. Plus, only generalities are given at the federal level and the states are left to fill in the details.
While the September 2010 health care reform changes technically went into effect on September 23, health plans are not obligated to introduce the new policy until the renewal date, which for most health insurance plans is on January 1. Whether you plan renews then or sometime between now and then, you surely want to know what California medical insurance changes you will see go into effect. There are a few changes, five of which are listed here:
1. Lifetime caps will lift. This means that ceilings imposed on health care plans will be removed altogether. Prior to this law passing, insurance companies capped policies at about $1 million to $2 million. For people with heightened medical issues, this will be a great benefit.
2. People under age 19 cannot be excluded coverage because of pre-existing conditions.
3. Dependents will remain on their parent’s policy until age 26. Prior to this federal change, states set their own ages, usually between 21 and 23.
4. Annual policy limits cannot be lower than $750,000 for benefits considered essential. These include maternity, prescriptions, hospital visits, and emergency service.
5. New plans have additional responsibilities. Any preventative service labeled “highest recommendation” by the federal government must receive coverage. Plus, California medical insurance cannot charge higher co-pay amounts for emergency service sought outside the network.