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Health care reform timeline 2010 Posted: September 23rd, 2010

By Megg Mueller

With the passage of the Affordable Care Act, in March 2010, came several legislative changes to health care and health insurance. Many of the provisions don't take affect until 2014; however, a number of the law's provisions are slated for implementation in 2010.

June 2010

Starting in June 2010, Medicare rebate checks will be mailed to Medicare beneficiaries who fall into the Medicare "Donut Hole." Qualifying Medicare beneficiaries, those who have the Medicare prescription drug plan and hit their coverage limits, receive a one-time $250 rebate. The rebate is designed to help cover gaps in Medicare coverage. More discounts and subsidies are to be phased in over time until the Medicare "Donut Hole" is eliminated by 2020. Seniors should be automatically mailed a rebate check once the coverage limit has been reached.

Seniors should be wary of individuals who contact them regarding the one-time Medicare rebate check. Never provide your personal information, such as your Social Security number or bank account information, to individuals who claim they need information to process your rebate check.

July 2010

In July 2010, high-risk health insurance pools, created in each state, are designed to provide coverage for those who are unable to purchase health insurance because of a pre-existing condition. Each high-risk pool is to be run by the state or federal government and can be accessed by those who have been unable to purchase coverage due to a pre-existing condition for at least six months. The pools are a stop-gap measure until health care exchanges are established in 2014. Premiums vary depending on which state you live in, but out-of-pocket limits are set at $5,950 for individuals and $11,900 for families (excluding premiums).

September 2010

On Sept. 23, 2010, a host of new rules affecting health insurance coverage and health insurance companies go into effect:

  • New plans must cover a number of preventive services like mammograms and colonoscopies for free. No deductible, co-pay or co-insurance will be charged.

  • Coverage cannot be denied or cancelled when people get sick. In the past, insurance companies have used errors on applications to deny coverage, but this practice (called rescission) is now illegal.

  • Coverage cannot be denied to children under 19 with pre-existing conditions.

  • Insurers cannot place lifetime caps on coverage. Annual limits must be approved by the government.

  • Adult children will be eligible for coverage as dependents on their parents' polices until age 26, as long as benefits are unavailable through an employer.

  • New plans must include a way to appeal coverage determinations or claims. An external review process must be established.

  • Lifetime dollar limits on essential benefits, like hospital stays, are no longer allowed.

Other provisions are scheduled to take effect in 2010, but do no have set implementation dates. These provisions include additional funding for rural health care centers and community health care centers, as well as increased spending on prevention and public health programs like quitting smoking and weight management.