Starting this week, insurers are prohibited from setting lifetime limits and restricted in setting annual limits on what they will pay for care, banned from rescinding policies after a beneficiary becomes sick and prohibited from excluding children with preexisting conditions.
The law also provides additional benefits for the elderly, including free wellness checkups, and bars insurance companies from setting lifetime limits on care costs.
The law also prohibits health insurance company practices that were previously legal, including refusing to sell plans to children and adults with pre-existing medical conditions, setting lifetime limits on medical coverage that cut people off when their expenses get too high, and charging higher premiums to women.
Some ministries have annual or lifetime limits, or set other restrictions on what they will cover ― for example, leaving out inpatient psychiatric care.
Also this year, the law bans lifetime limits on benefits, which are often set at $1 million or $2 million — an amount that someone with a serious illness can easily exceed, said Ron Pollack, executive director of Families USA.
Language in earlier versions of the Senate bill and in the bill adopted by the House last month would eventually bar insurance companies from setting annual limits on benefits, and would immediately bar lifetime limits.
Of employers in 26 states surveyed by the General Accounting Office, 14percentt -- or between 9,000 and 13,000 employers -- continued to set lower lifetime dollar limits for mental health treatment.
The Affordable Care Act prohibits insurers from placing lifetime limits on most benefits that consumers receive and sets a minimum for annual dollar limits.
Most of those companies, by their own account, had lifetime limits on mental health benefits of $100,000 or less, but set higher ceilings for medical and surgical benefits.
They can't impose arbitrary lifetime limits.
