The Affordable Healthcare Act (ACA) ushered in a new Bill of Rights for health care consumers. These rights, implemented within the regulations associated with the Affordable Care Act, provide a variety of consumer protections, all of which will be fully implemented by 2014. With the Bill of Rights, patients now:
Can Obtain Coverage for their Children with Pre-existing Conditions: Children under 19 cannot be denied medical coverage solely due to a pre-existing condition. In 2014, this will apply to Americans of all ages. This provision may make health insurance available to anywhere from 4 to 17 million children with conditions such as asthma or diabetes who, prior to the ACA, could be denied coverage.
Have a Guarantee on their Choice of Doctor: Consumers can select any available participating primary care provider within their plan’s network as their primary doctor.
Can Extend Coverage for Young Adult Children: Consumers under the age of 26 may be eligible to be covered under their parent’s health plan. Children under 26 can remain on a parent’s health insurance plan even if the child is married or living outside the parent’s home.
No Longer Face Lifetime Limits on Coverage: Lifetime dollar limits on essential benefits are banned for all new health insurance plans. AARP has estimated that 100 million Americans have health insurance with lifetime limits.
Be Protected Coverage Cancelations Due to Honest Mistakes on Insurance Forms: Insurance companies can no longer cancel coverage just because the consumer or employer made an honest mistake when filling out insurance forms.
May Review of Premium Increases Before They Are Implemented: Insurance companies that increase their premium by a significant amount must submit the increase for public review.
Have at least 80% of their Premiums Spent on Health Care Services: Insurance companies that provide group insurance must spend 80% of premium dollars primarily on health care instead of administration costs.
Do Not Have to Pay More for Emergency Treatment at Out-Of-Network Facilities: Consumers that seek emergency care at an out-of-network hospital are not required to pay higher copayment fees.
Have the Right to Appeal Coverage Decisions: If a payment for treatment or service is denied by the insurance company, consumers now have the right to file an appeal for a review of the denial.
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