What to Expect from Health Care in 2011

There is a lot that will change after the ball drops in Times Square in a few weeks.  To help keep you updated, I want to keep posting lists from different sources.  Everyone focuses on something different (good or bad).  Today’s is from CNN News.  My notes will be in orange:

Within the first year

• Young adults will be able stay on their parents’ insurance until their 26th birthday. (more expensive for employers, but good for college-aged kids who normally don’t buy health insurance)

• Seniors will get a $250 rebate to help fill the “doughnut hole” in Medicare prescription drug coverage, which falls between the $2,700 initial limit and when catastrophic coverage kicks in at $6,154. (so the rebate will cover one prescription to ‘help’ with the $3,454 gap)

• Insurers will be barred from imposing exclusions on children with pre-existing conditions. Pools will cover those with pre-existing health conditions until health care coverage exchanges are operational. (covering an existing condition without charging a higher rate means everyone’s premium will go up.  I’m glad they are covering sick kids, but we have to understand we will all be paying rather than raising the rate for just the family)

• Insurers will not be able to rescind policies to avoid paying medical bills when a person becomes ill. (usually when this happened, it was because someone lied on their application.  fraud will hopefully still be treated as fraud)

• Lifetime limits on benefits and restrictive annual limits will be prohibited.

• New plans must provide coverage for preventive services without co-pays. All plans must comply by 2018. (this may encourage some people to go out and get a new plan, but check to see if your plan will be grandfathered with other perks going away before you give it up just for the $0 preventative care co-pay)

• A temporary reinsurance program will help offset costs of coverage for companies that provide early retiree health benefits for those ages 55 to 64.

• New plans will be required to implement an appeals process for coverage determinations and claims. (raising the cost of administration overhead for insurance companies, which is about to be capped at 15% of the premium we pay to them)

• Adoption tax credit and assistance exclusion will increase by $1,000. The bill makes the credit refundable and extends it through 2011.

• A 10 percent tax will be imposed on amounts paid for indoor tanning services on or after July 1. (sorry, Snooki, but we have to squirrel that money away for melanoma detection programs)

• Businesses with fewer than 50 employees will get tax credits covering 35 percent of their health care premiums, increasing to 50 percent by 2014. (these tax credits are very hard to get because you have to average in part-time employees to equal out as full time employees, then count them as part of the percentage of employees you must be paying more than 65% of the premium on in order to get the credit.  Confusing?  You bet.  Basically, you have to have a small business and be paying most of the premium for all of your employees, but the more they get paid, the less of a credit you’ll get.)

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