Three months ago President Obama signed the Health Reform
Bill. More and more information is made available to the public each day;
however, there are still many questions to ask. Below is a breakdown of how the
new health reform will be affecting different groups.
What does it mean for
children?
Plans beginning as of September 23, 2010 will no longer be
able to deny coverage to children under age 19 due to pre-existing conditions.
Insurance carriers will no longer be able to cancel coverage for children if
they get sick or charge larger premiums for them if they are sick. Many
companies have already embraced this change and are following this legislation
as of right now. The change addresses insuring children before adults because
the percentage of children who are uninsurable makes up a much smaller portion
than the percentage of uninsurable adults. Therefore, it will be less expensive
for companies to insure all children and they will have until January 1, 2014
to make adjustments that will allow for adults to be added to this new
legislation.
Also, young adults up to age 26 will be able to stay on
their parent's policy no matter what their student, marital, or employment
status is. This is not mandatory, but is an option that will be available to
plans starting on or after September 23rd and already is available
in some policies as right now. This goes for employer sponsored plans and
individual plans. Existing group policies will have the choice to have certain
limitations to this benefit.
What does it mean for
small businesses and employees?
Small businesses will not be required to insure their
employees if they have less than 50 employees; however those with less than 25
employees will receive a tax credit for doing so if they qualify.
Beginning in 2010, small employers with fewer than 25 full
time equivalent employees who make on average less than $50,000 annually will
receive a maximum tax credit of 35% if they make insurance available to their
employees and pay at least 50% of the employee-only premium. If you have any
questions about whether or not your business qualifies for the tax credit,
visit http://www.irs.gov/pub/irs-utl/3_simple_steps.pdf
where you can find a worksheet that will
help you.
The tax credit is available to for-profit as well as
non-profit businesses.
What does it mean for
individuals?
If you are currently on an individual policy, you will see a
few changes this year with more to come in the years to follow. The changes
taking place this year include: plans that start on or after September 23, 2010
will no longer be able to impose lifetime limits on coverage and insurance
companies will no longer be able to cancel coverage if someone gets sick. Also,
all plans will be able to cover children up to age 26 no matter what their
marital, school, or employment status is.
Beginning in 2011, individual plans will have to cover
preventive services with no cost sharing. The state of Texas already has a health risk pool
available to you if you are unable to get insurance from your employer or
through an individual plan. However, by 2014, there will be a new insurance
exchange set up that will give people more insurance plan options.
What does it mean for
individuals over the age of 65?
If you are enrolled in Medicare Part D who have reached the
prescription "doughnut hole", you will receive a rebate check from the federal
government in the amount of $250 this year. This aid will be tax free; you will
not have to report it as income. The first set of checks went out June 10th
of this year and more checks will go out each month. You will not need to do
anything in order to receive your check. CMS will automatically be notified
once you have reached the doughnut hole and you will be put in the system to
receive a check. If anyone calls or comes to your door asking for your
information including your Medicare number in order to give you your rebate
check, please report them to 1-800-HHS-TIPS (1-800-447-8477) or email HHSTips@oig.hhs.gov .
Other benefits available to you include annual physicals and
free preventive services beginning in 2011. The annual open enrollment period
for Part D policies for 2010 and 2011 will still be November 15 to December 30,
however, beginning in 2012, open enrollment will change to October 15 to
December 7.
If you want to learn
more about preventing Medicare fraud, visit www.stopmedicarefraud.gov .
*Since the health
reform bill passed in late March, there have been constant changes and new
information. For the most accurate and up to date information, visit the
government's website dedicated to informing the public; www.healthcare.gov.