Federal laws help regulate health care protection for individuals.
Federal health insurance laws regulate health care insurance providers, mandating coverage for certain benefits or limiting premiums for businesses who choose to offer employee coverage. In addition, laws have been established to allow individuals to keep their coverage when switching health plans.
Health Insurance Portability and Accountability Act
The Health Insurance Portability and Accountability Act (HIPAA) protects millions of Americans, by providing continuity of insurance coverage through portability. The law limits exclusions concerning preexisting medical conditions; prohibits discrimination in enrollment and in premiums pertaining to health status-related factors for employees and their dependents; and gives individuals the right to enroll in new coverage when previous health care lapses, or when they get married or add dependents.
Employee Retirement Income Security Act
For individuals with pensions and health plans in the private sector, the Employee Retirement Income Security Act of 1974 (ERISA) sets minimum standards of protection under federal law. ERISA requires health plans to establish grievance and appeals procedures, provide important information about plan features and funding, outline fiduciary responsibilities for those who control and maintain plan assets, and allow the right to sue for benefits and breaches over fiduciary duty. The Act does not provide for group health plans overseen or established by government agencies, and churches for their employees; nor does it cover plans outside the United States, among other things, according to the U.S. Department of Labor.
The Women's Health and Cancer Rights Act
The Women's Health and Cancer Rights Act governs insurance coverage for women who have undergone a mastectomy for breast cancer. The law provides that coverage include all stages of breast reconstruction where the mastectomy was performed, any reconstruction or surgery pertaining to the second breast to provide a symmetrical appearance, and treatment of physical complications from the mastectomy surgery and prosthesis. The law covers individuals who receive mastectomies without the cancer diagnosis if the group plan covers mastectomies. The law does not require any minimum hospital stays.
Tags: health plans, health care, Health Insurance, Women Health Cancer, Cancer Rights, coverage when, Employee Retirement
