What New Health Insurance Laws Mean to You
By: Tucker Thompson, for Collin SENIOR Magazine
The new Patient Protection and Affordable Care Act continues to unfold with its changes to health insurance laws taking effect over the next few years. Whether you’re under or over 65, this article highlights changes you should know about.
Insurance plans will soon be required to cover 100% of the costs of approved preventive services. Insurers won’t be allowed to rescind coverage except when people purposefully provide false information. Every state will be required to establish temporary high risk pool plans for those with preexisting conditions who’ve been denied coverage. Texas already has its plan in place.
Insurance plans won’t be able to impose caps on annual or lifetime benefits. Individuals under age 19 soon can’t be denied coverage based on any pre-existing conditions and plans will be required to cover dependents up to age 26. If you’re over 55, just retired or laid off from an employer who provided you with medical insurance, a new temporary reinsurance program will be available to you. New tax credits have been established to encourage small business owners to offer health insurance for employees with laws and benefits differing depending on the size of the company.
Changes and improvements have been made to Medicare, Medicare Supplements, and Medicare Advantage Plans. As many know, Medicare alone doesn’t pay for all medical care. Highlights of some changes follow.
Basic Medicare: Those who reach the Part D Gap in 2010 will receive a $250 rebate. The threshold where Part B premiums increase for individuals with annual incomes above $85,000 (couples above $170,000) freezes from 2011-2019. To encourage more physicians to accept Medicare patients, the government is offering a 10% bonus payment to primary care physicians from 2011-2015 and improve prevention by covering only proven preventive services, eliminating cost-sharing in Medicare and Medicaid for these services. A hospital value-based purchasing program will be implemented that pays hospitals based on quality measure performances and also extends the Medicare physician quality reporting initiative beyond 2010. Plans are to extend these value-based programs to skilled nursing facilities, home health agencies, and ambulatory surgical centers.
Medicare Supplement Plans (insurance that covers some or all of the gaps that Medicare does not pay for) are introducing effective June 1, 2010 two new choices, Plans M and N. M Plans will cover 50% of the Part A hospital deductible. Neither M or N will, however, pay the Part B deductible or any Part B excess charges. N Plans will cover 100% of the Part A deductible, but will charge $20 per office visit and $50 per ER visit. All other benefits in both Plans M and N are similar to the benefits offered in Medicare Plan D supplements. Additionally, they are very competitively priced, and like all other Medicare Supplement plans, have no networks of physicians or hospitals that you must be confined to. (Please remember Plans refer to hospital and supplemental medical insurance while Parts, like Part D, refers to Medicare prescription drug insurance.)
Medicare Supplement Plans E, H, I and J will no longer be offered. Plans D and G will no longer cover At-Home Recovery. The G Plan will pay 100% (up from 80%) of any Medicare Part B Excess Charges, but won’t cover the Medicare Part B deductible. Plan F continues to offer the most comprehensive coverage in Medicare Supplement plans.
How many of these changes will be funded are highlighted here. Beginning in 2013, a
0.9% increase to the 1.45% Medicare payroll tax will be imposed on individuals with earned income over $200,000 (joint filers with earned income over $250,000). Also beginning in 2013, there is a proposed 3.8% Medicare tax on certain investment income. A 10% tax on indoor tanning salons is imposed. Tax increases are in place for pharmaceutical and medical device companies, a 2.3% excise tax on the sale of any taxable medical device, as well new tax laws for health insurance companies. Unearned income greater than $200,000 for individuals ($250,000 for couples) will see a new 3.8% tax. Taxes on distributions for non-qualified expenses from HAS’s, Archer MSA’s or Cadillac plans will increase.
Tucker Thompson has worked in the insurance field for 19 years and spoken widely. He is a licensed health, long term care and life insurance agent, a certified senior advisor, and Senior Executive with the local office of Benchmark Financial Services. He welcomes calls at 469- 247-1829 or 888- 247-1829 if you have any questions on any of the various plans now available or would like more information on any of the changes.