Pre-ExistingSummary: Healthcare Reform is upon us with some of the most monumental provisions becoming effective in 2014, such as the removal of pre-existing conditions. As of January 2014, insurance companies can no longer deny coverage, deny claim payments, or charge higher premiums for individuals with pre-existing conditions.

In keeping with the holiday traditions, we are focusing on the 12 days of Obamacare for the month of December and early into January. As such, we are up to the 4th day:

On the 4th day of Obamacare, Obama gave to me:

No Pre-Existing

Preventive Care

Healthcare Exchanges

And an Individual Mandate

Grandfathered Pre-Existing Plans

For years, pre-existing has been a thorn in many individual’s sides. Historically, consumers have been denied coverage if they had a pre-existing condition and/or charged much higher premiums. The Affordable Care Act is putting an end to this. Of course as with anything related to the ACA, there are exceptions. The exception to the pre-existing is for grandfathered individual insurance plans. They are not required to cover pre-existing conditions. Grandfathered plans are those that were purchased on or prior to March 23, 2010. These plans may lose their grandfathered status if substantial changes are made to the policy. Additionally, insurance companies are required to disclose if the policy is deemed to fall under the grandfather provision.

Pre-Existing Phase Out

As with many of the provisions of the ACA, the pre-existing clause is phased in. Beginning in 2010, the provision became effective for children. This provision becomes effective for adults in 2014. In order to bridge the gap between 2010 and 2014, the federal government created the Pre-Existing Condition Insurance Plan (PCIP) for individuals who didn’t have employer sponsored healthcare. As of February 2013, this plan was frozen in terms of new enrollment as the funding was no longer guaranteed.


Health Reform and Women

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The ACA as of 2014 will finally remove the barrier of pre-existing conditions faced by many Americans in terms of insurance coverage. Insurance plans are no longer allowed to discriminate against those with pre-existing conditions or charge higher premiums on this basis.

To learn more about the Affordable Care Act and the provision which are already effective as well as those still to come, please click below.

The Affordable Care Act in a Nutshell

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