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New rules may affect your health insurance coverage
October 8th, 2010
Catholic Online (www.catholic.org)
Many employees will be reviewing their health insurance coverage this year, and going through the higher premiums, added co-payments and expanded deductibles. Along with the expected cost increases will come some significant changes that have been mandated by the health care reform law. These changes could affect everything from the dependents on individual coverage to the size of your deductible.
LOS ANGELES, CA (Catholic Online) - Chief among them will be the fact that insurance plans will have to offer free preventive care. That means they must cover cancer screenings, blood pressure, diabetes and cholesterol tests, flu shots and other preventive services without charging you a co-payment, co-insurance or deductible.
With 100% of preventive care covered, you may decide you can afford to increase your deductible, which usually results in lower premiums. But first, make sure your plan is required to comply with the rule. Insurance plans that were in existence before March 23, when the health care reform bill was signed into law, may be eligible for "grandfather" status, which means they're not required to comply with the requirement.
There are also new restrictions on spending accounts. Health care flexible spending accounts let you contribute pretax dollars to pay for unreimbursed medical and dental expenses. The downside to these plans is that most employers require you to forfeit any money that hasn't been used by year's end.
Starting in 2011, over-the-counter medications won't be covered by flex accounts unless you have a doctor's prescription. Even with the new restrictions, flex accounts can save you a lot of money. In addition to prescription drugs, you can use the money for co-payments, deductibles, and dental and eye doctor appointments.
There will be expanded coverage for adult children. Under the new rules, health insurers must allow adult children to remain on their parents' employer-provided group plans until age 26. This is the most significant change taking effect this year. This doesn't mean your child will be eligible for coverage immediately. While the provision takes effect Sept. 23, plans aren't required to extend coverage until they start a new plan year, which for most is Jan. 1.
Also, coverage isn't automatic. To obtain the extended coverage, you'll need to add your child when you enroll in your plan for next year. If your child becomes eligible after the enrollment period ends, your employer will be required to give you 30 days to enroll.