New healthcare provisions
Insurers must allow parents to keep an adult child up to age 26 on their health plan. And those young adults can't be charged more than any other dependent. Some insurers began this policy early — during the summer.
Insurers cannot charge co-pays or deductibles for preventive services like breast cancer screening and cholesterol tests. However, grandfathered plans — those that don't change at all from the previous plan year — do not have to follow this new requirement.
Insurers must cover children up to age 19 with a pre-existing medical condition: New individual plans and all group plans — like those you get at work — cannot refuse to cover a child. But, grandfathered individual health plans can refuse to cover a child.
Insurers can no longer cancel your coverage once you get sick, a practice known as rescission. However, if you committed outright fraud and intentionally hid something, your insurer can refuse to pay.
Under the new law, individuals — not their insurance company — get to decide which primary physician, gynecologist, obstetrician and pediatrician they see among their plan's list of approved providers.
Insurance companies cannot require additional payments for visiting an emergency room that is out-of-network for a medical emergency. But grandfathered plans are exempted.
Limits on the amount an insurance company will pay out in a given year or over a lifetime will be phased out and eventually eliminated.
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