Health law brings preventive care without copays

[ProSense]

Source: Associated Press

New health insurance policies beginning on or after Sept. 23 must cover — without charge — preventive care that's backed up by the best scientific evidence. Most people will see this benefit, part of the Obama administration's health care overhaul, starting Jan. 1.

The list includes tests strongly recommended by the U.S. Preventive Services Task Force, an independent advisory panel that evaluates research.

Of note for men: Screening for prostate cancer isn't included on the list because its benefits haven't been conclusively shown by the best research, at least to the high level required by the law.

Of note to women: Those in their 40s and at average risk for breast cancer can get a mammogram every one to two years as part of the free preventive care. That's in line with American Cancer Society advice. But it's more generous than the Preventive Services Task Force, which says most women don't need mammograms in their 40s.


Read more: http://news.yahoo.com/s/ap/20100922/ap_on_he_me/us_health_care_preventive_glance_1

[kestrel91316]

1. Lovely if one can afford a policy. Or if one can find an insurer to process

your application all the way in CA if they suspect you might have any preexisting conditions they aren't allowed to deny you coverage over.

[ProSense]

2. This isn't about the high-risk pool. n/t

[TomCADem]

3. AP - "Health law kicks into 2nd gear; does it help me?" - Actually Discusses Benefits!

Most of the corporate media focuses on polls, right wing talking points, and discussions of whether health care reform has been appropriately "sold." Here is a rare news article that discusses the substance.

http://www.google.com/hostednews/ap/article/ALeqM5g8w9MBW0oMvGXF-1tmQSZzXD3rVgD9ID4AFG0

Q: What are some of the new benefits?

A: Free preventive care, for one. Some people will no longer have to pay copays, coinsurance or meet their deductibles for preventive care that's backed up by the best scientific evidence. That includes flu vaccines, mammograms and even diet counseling for adults at-risk of chronic disease.

* * *
Q: What other changes start Sept. 23?

A: If you go to an emergency room outside your plan's network, you won't get charged extra. Patients will be able to designate a pediatrician or an ob-gyn as their primary care doctor, avoiding the need for referrals that are required by some plans.

Q: I've heard lifetime limits are being eliminated. What does that mean?

A: Millions of Americans have insurance that sets a cap on what their insurance will pay to cover their medical costs over a lifetime. The caps have left very sick patients with medical bills topping $1 million or $2 million high and dry. These lifetime limits will be eliminated for plans issued or renewed on or after Sept. 23.

Those who have maxed out because of the caps but remain eligible for coverage must be reinstated on the first day of the plan year that begins on or after Sept. 23.

Q: What about annual limits?

A: Plans issued or renewed on or after Sept. 23 can't have annual limits lower than $750,000. Annual limits will be eliminated entirely by 2014.

[Gormy Cuss]

9. Somebody's finally sending out good PR press releases.

Those provisions of the bill, starting right now, are things that should've been talked up ad nauseum from the day he signed it -- and talked up not just on blogs and other web sites but in traditional news media.

While it's still far from the health care reform we need, it IS a good start at removing some of the worst things wrong with private health insurance policies, like "pre-existing condition" clauses and lifetime limits.

But that "free" preventive care is nothing of the sort. It's only free of co-payments and guaranteed as covered (both good changes, but not free.)

[w4rma]

4. Very good. (nt)

[woo me with science]

5. I'm underwhelmed.

You get a free yearly physical and gynecological appointment. Whoopie.

I know people who have plans just like this already.

You pay 400 to 800 dollars per month for your coverage. Yet you can go to the doctor twice a year.

Anything beyond these two appointments is applied to your deductible, which for people who are scraping to afford the cheapest insurance policies is often several thousand dollars. That means that if anything is found during these "preventive" visits, the person is screwed anyway and does not have the means to address the problem.

People on these plans cannot even afford to go to the doctor with a minor infection, because everything is out of pocket, and escalating costs are not being controlled. A simple visit to a doctor that would cost 20 bucks in Britain is easily several hundred dollars gone in one fell swoop here. So people don't go.

Then they end up in the emergency room, where they refuse major tests and pay 2 grand for a little palliative care for a couple hours.

People are facing the same problems with cost that they were facing before this legislation was passed. The major difference is that you have now mandated them to buy insurance they cannot afford to use.

Rather than throwing a bone of two free visits per year to people who are paying half a grand to a grand per month out of pocket, how about controlling spiraling costs so that people can actually afford to see a doctor when they are sick?

[leftyladyfrommo]

8. That would be me.

I hate my health care. It's just me. I have never had a claim. So far it is $500 a month with a $1500 deductible. After paying the premium I can't afford anything else.

Fortunately I am healthy. And I am afraid to not carry the insurance. One day in the hospital can run $40,000 - two days and I would be bankrupted.

[Gecko6400]

6. Nice, but. anyone who believes

that this will not be built into the price of the premiums is somewhat dim witted.

[Zorra]

7. What elements specifically constitute "substantial changes"?

"Many employer-based plans won't be affected by these new requirements if they are "grandfathered" under the health overhaul law. But as those plans make substantial changes they'll lose their grandfathered status and then have to meet the requirements"

Hopefully, raising the cost of a plan constitutes "substantial changes".

That's always a pretty substantial change for most of us.

If an employer's insurer raises the cost of a plan, do they lose their grandfathered status and then have to pay for the costs of this (limited) preventive care?

This entire health care bill appears to be one enormous loophole where our money will drop into in order to insure that insurance companies can continue to make inordinate profits.

Maybe I'm just a silly, dumbass professional leftist that deserves to be chided like an errant child by the WH, but I really do wish we had "Canadian style" healthcare and until I see the money I'm gonna be real skeptical about how beneficial this bill actually is.

[ItNerd4life]

10. This is BS. It doesn't make them cover the reading, just the test.

Currently, many insurance companies cover the test, but they don't cover the readings of the tests.
The mammogram is covered, but reading the results is not. (Just happened to us recently). Government, outsmarted by insurance companies.