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Thread: How does these changes Effect us?

  1. #1
    Senior Member Level 8 Mark Rosenthal's Avatar
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    Default How does these changes Effect us?

    I know all of this goes into effect today. If I have a child with a pre-existing condition, do I just apply to a company or what? Can one of you health agents go over some of these changes with us?



    1. Insurance companies will no longer be able to deny children coverage for pre-existing conditions.

    2. Children of parents with insurance will be allowed to remain covered under those policies until the age of 26.

    3. Insurance companies will be forbidden from terminating coverage for any other reason than customer fraud.

    4. Insurance companies will no longer be able to cap the amount of benefits and treatment a person can receive in a lifetime.

    5. Insurers can no longer charge customers for preventive services like mammograms and colonoscopies.

    6. High-risk pools are mandated to cover those who have been denied coverage because of pre-existing conditions.


  2. Mark Rosenthal
    I have not been on this forum in years and it wont allow me to delete my outdated old post. If you want to contact me, you can find me on Linkedin at https://www.linkedin.com/in/connectwithmarkrosenthal/

  3. #2
    Senior Member Level 2 Norwayguy's Avatar
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    Default

    I don't sell health but will try and answer your questions Mark.

    I know all of this goes into effect today. If I have a child with a pre-existing condition, do I just apply to a company or what? Can one of you health agents go over some of these changes with us?



    1. Insurance companies will no longer be able to deny children coverage for pre-existing conditions.
    This is true if a carrier offers a Child only plan you can apply and the carrier can not deny the child a policy. Unfortunatly many carriers have dropped child only coverage, so you may need to apply for a family policy a policy that besides the child has at least 1 adult (who is still underwritten and approved) on it.

    2. Children of parents with insurance will be allowed to remain covered under those policies until the age of 26.
    There really isn't a question here. If you have a plan that includes coverage of a child they will be able to remain on your policy.

    3. Insurance companies will be forbidden from terminating coverage for any other reason than customer fraud.
    4. Insurance companies will no longer be able to cap the amount of benefits and treatment a person can receive in a lifetime.
    Yes no longer will the policy have an annual or lifetime limit on total policy benefits...It is still possible for a policy to limit certain things on an annual basis such as the amount of DME covered. Please note part of your premium increases will be caused by this additional risk to the carrier. Its also interesting to wonder why after 2014 and everyone should be GI that this clause would be needed. Reach your policies limits or coming close no problem just purchase a new policy...your GI right this is what I am living with in my state already. The state recently passed a law disallowing policy limits...We are already GI and have 1 carrier Anthem BC, so I guess things don't always work out the way Congress or the Legislature intends.

    5. Insurers can no longer charge customers for preventive services like mammograms and colonoscopies.
    LOL, Yes the policy can not require you to pay a deductible or co-pay for these services but does anyone believe they will not be included in the carriers premium...its not like the DRs and Labs are no longer charging for these preventive measures.

    6. High-risk pools are mandated to cover those who have been denied coverage because of pre-existing conditions.
    These were the very first measures of the new law to go into effect. It allows those who have been denied coverage due to Pre-Existing conditions and have been without coverage for 6 months to purchase a policy with substantially reduced premium than if the carriers could price these policies accordingly. You can visit www.pcip.gov to get more info and link to a plan in your state.
    Peter G Langelier
    plangelier@langelierinsurance.com www.langelierinsurance.com
    Licensed Resident Agent Maine Life/Health & Variable Contracts

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