Adirondack Health Institute News

Affordable Care Act Fact of the Day – Expanding Coverage for Early Retirees

Too often, Americans who retire without employer-sponsored insurance before they are eligible for Medicare, see their life savings disappear because of high rates in the individual market. Through the new Health Insurance Exchanges,  employers can preserve coverage for early retirees until more affordable coverage is available.  The new law creates a $5 billion program to provide needed financial help for employment-based plans to continue to provide valuable coverage to people who retire between the ages of 55 and 65, as well as their spouses and dependents.

Applications for employers to participate in the program were available June 1, 2010.

For more information on the Early Retiree Reinsurance Program, visit www.ERRP.gov.

 

Affordable Care Act Fact of the Day – Extended Coverage for Young Adults

Under the law, young adults will be allowed to stay on their parents’ plan until they turn 26 years old (this right does not apply if the young adult is offered insurance at work).  The young adult can be married and still be eligible for their parents’ health insurance. This is also available to step-children. This became effective for health plan years beginning on or after September 23, 2010.

Affordable Care Act Fact of the Day – Providing Access to Insurance for Uninsured Americans with Pre-Existing Conditions

Effective July 1, 2010, a Pre-Existing Condition Insurance Plan is available and provides new coverage options to individuals who have been uninsured for at least six months. States have the option of running this program in their state. If a state chooses not to do so, a plan will be established by the Department of Health and Human Services in that state.  

In New York State, this insurance plan is called the New York Bridge Plan and is run by Emblem Health.

For more information on the New York Bridge Plan in Clinton, Essex, Franklin, Hamilton, Warren or Washington counties, contact Erika Walker at ewalkerahi@medserv.net or (518) 761-0300, ext 31252.

Affordable Care Act – Fact of the Day – Providing Free Preventive Care

Effective September 23, 2010, all new insurance plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.

Affordable Care Act Fact of the Day – Offering Relief for Seniors who have hit the Medicare Prescription “Donut Hole”

An estimated four million seniors will reach the gap in Medicare prescription drug coverage known as the “donut hole” this year.  Each eligible senior will receive a one-time, tax-free $250 rebate check.  The first checks were mailed in June of 2010.

Affordable Care Act Fact of the Day – Providing Small Business Health Insurance Tax Credits

The Affordable Care Act provides up to 4 million small businesses tax credits to help the provide insurance benefits to their workers. The first phase of this provision provides a credit worth up to 35% of the employer’s contribution to the employee’s health insurance.  Small non-profit organizations may receive up to a 25% credit.  This is now in effect.

Affordable Care Act Fact of the Day – Establishment of Consumer Assistance Programs in the States

Under the Affordable Care Act, states that apply, receive federal grants to help set up or expand independent offices to help consumers navigate the private and public health insurance system.  These programs also help consumers with medical bills, finding prescription coverage, navigating Medicare and educating on rights and policies.

Erika Walker is the Community Health Advocate for Warren, Washington, Essex, Clinton, Franklin and Hamilton counties.  Erika can be reached at 518.761.0300, ext 31252.

Affordable Care Act Fact of the Day – Regulating Annual Limits on Insurance Coverage

Under the new Health Care law, insurance companies’ use of annual dollar limits on the amount of insurance coverage a patient may receive will be restricted for new plans in the individual market and all group plans. 

In 2014, the use of annual dollar limits on essential benefits like hospital stays will be banned for new plans in the individual market and all group plans effective for health plan years beginning on or after September 23, 2010.

Affordable Care Act Fact of the Day – Prohibiting Lifetime Limits on Insurance Coverage

Under the Affordable Care Act, insurance companies will be prohibited from imposing lifetime dollar limits on essential benefits like hopsital stays. This is effective for health plan years beginning on or after September 23, 2010.

Prohibiting Insurance Companies from Rescinding Coverage

In the past, insurance companies could search for an error or other tenchical mistake on a customer’s application and use this error to deny payment for services when he or she got sick. The health care law makes this illegal effective for health plan years beginning on or after September 23, 2010.