Wednesday, July 7, 2010

Private Health Insurance Benefit Requirements

Health insurance companies are required to cover childrens' vaccinations.


In 2010, Congress passed the Affordable Care Act to help ensure that all Americans have access to affordable quality health care. The law mandates that private health insurance providers offer certain benefits to all policy-holders and their dependents, regardless of the type of health plan they carry.


Preventative Care


As of September 23, 2010, federal law requires health insurance companies to provide certain preventative screenings to all policyholders depending on age. For example, women are allowed mammograms at age 40, while all adults are afforded a colonoscopy upon reaching age 50. The screenings are provided free to the patient with no responsibility of co-pays, coinsurance or deductibles. Other covered preventative care services include vaccinations, cholesterol checks and glucose screenings. Also, beginning January 1, 2011, the law requires that Medicare cover senior citizens for annual wellness check-ups and preventative medicine.


Children


Beginning September 23, 2010, the law required that all health insurance companies accept children under the age of 19 regardless of any previous medical conditions, treatments, family history or use of prescription medications. This law extends to all citizens, beginning in 2014, but until then, children must be accepted for all insurance plans. As they grow older, children are also allowed to stay on a parent's health policy until age 26, provided the adult child is not offered insurance through an employer.


Unlimited Benefits


The Affordable Care Act has a provision that requires all health insurance companies to provide benefits for covered medical treatments without imposing a lifetime limit. Additionally, a phase out of annual limits began on March 23, 2010. The phase out will reach completion on January 1, 2014, slowly increasing the required annual coverage amounts until that date. This benefit requirement only applies to treatments considered essential to the patient, such as hospital stays or life-saving procedures. Plan providers may obtain a waiver for this benefit if allowing unlimited coverage could mean an increase in monthly premiums for a particular patient.

Tags: insurance companies, health insurance companies, Affordable Care, companies provide, health insurance