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Affordable Health Care Act

02 Aug

photo from Hisham F. Ibrahim/Getty images

According to the recent U.S. Census Bureau and American Community Survey, nearly one in five Minnesotans of Asian American Pacific Islander (AAPI) descent is not insured1.  More specifically, one in six Cambodians in Minnesota do not have health insurance1.  Other Southeast Asians communities like the Hmong and Vietnamese join the Cambodian community in having the highest percentage of uninsured in Minnesota1.  In contrast, over 90% of Chinese, Laotian, Korean, Filipino and Asian Indians have health insurance.  Healthcare and health insurance is undoubtedly very important to Minnesota’s AAPI community.

On June 28th, 2012 the U.S. Supreme Court upheld the Affordable Care Act (ACA).  The new rules, consumer rights, and programs that the ACA brings will have a significant impact on our AAPI community in Minnesota. Here are some important details:

What you need to know

New Programs  

Affordable Insurance Exchanges (AIE) will be setup beginning in 2014 to help individuals and small businesses buy health coverage easier and at an affordable price.  You can compare health plans, have your questions answered, determine your eligibility for tax credits or health programs, and enroll in either public or private health plans.

The new law will also create Consumer Assistance Programs (CAP) to help you file complaints, enroll in health coverage, and become more educated about your rights and responsibilities.  Minnesota currently does not have a CAP. However, you may contact the Minnesota Departments of Health , and Commerce, or other agencies and organizations for assistance.  For consumer assistance contacts and information, please see: http://www.healthcare.gov/using-insurance/managing/consumer-help/mn.html

New Rights and Services 

Under ACA, you also have many new rights.  You have a right to appeal if your health insurance plan denies payment for a service or treatment.  You may ask your health insurance plan to reconsider their denial of payment.  If they still deny it, you may also ask for an independent external review from an independent review organization.

In addition to your new rights, you may also be eligible to receive preventive services at no cost.  These services however only apply to people enrolled in job-related health plans or individual health insurance policies created after March 23, 2010.  Please note that you may not be eligible if you are enrolled in a “grandfathered” plan.  You may also have to pay some costs for office visits.

Some of these preventive services include: blood pressure, diabetes, and cholesterol tests; cancer screenings including mammograms and colonoscopies; routine vaccinations; and counseling.  Today, August 1, 2012, coverage of preventive services especially for women, like well-woman visits; gestational diabetes screening; domestic and interpersonal violence screening and counseling; FDA-approved contraceptive methods; and more begins.  For a complete list of preventive services, please see: http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html

If your health insurance policy covers children, you may add or keep your children on your plan until they turn 26 years old, even if they are married, not living with you, attending school, not financially dependent on you, and/or eligible to enroll in their employer’s plan.

The new law prohibits insurance companies from denying coverage to children under the age of 19 and will expand to include all Americans regardless of age or gender beginning January 1, 2014.  This part of the law will apply to all job-related health plans and individual health insurance policies issued after March 23, 2010.  This will also apply to your plan when it begins a plan year or policy year on or after September 23, 2010.

You may be eligible to enroll in the Pre-Existing Condition Insurance Plan (PCIP) if you are a U.S. citizen or legal resident, have been denied health insurance because of a pre-existing condition, and have been uninsured for at least 6 months.  The PCIP program covers primary and specialty care, hospital care, and prescription drugs.  However premiums will differ depending on which state you live in and plan you choose.  In Minnesota, eligible residents can apply for the PCIP program run by the U.S. Department of Health and Human Services.  For more information about monthly premium costs and other costs, please see: http://www.healthcare.gov/law/features/choices/pre-existing-condition-insurance-plan/index.html

Please note that some insurance plans may be exempt from portions of the new health care law.  “Grandfathered” plans are one example and are exempt from most changes.

Some parts of the new health care law that DO apply to Grandfathered Plans and all other plans include: prohibiting lifetime dollar limits to key health benefits, disallowing plans to cancel your insurance coverage due to mistakes on your application, and extending coverage to your children until they turn 26 years old.

Other parts of the law that DO NOT apply to Grandfathered Plans and Job-Based Plans include:providing certain preventive services at no charge to you, offering new protection when appealing claims and denials, and protecting your choice of health care providers.  One portion   of the law that DOES NOT apply to Grandfathered Individual Plans is the elimination of excluding children due to a pre-existing condition.  For more information, please see: http://www.healthcare.gov/law/features/rights/grandfathered-plans/index.html

The new health care law will also create an Early Retirement Reinsurance Program (ERRP) to provide financial relief for employers so retirees can receive quality, affordable insurance.  Please visit the ERRP website if you are interested in participating in the ERRP program.  www.ERRP.gov

For a complete list of participating businesses in Minnesota, please see the link below.  The list is updated monthly as applications are approved by the U.S. Department of Health and Human Services. http://www.healthcare.gov/law/features/employers/early-retiree-reinsurance-plan/mn.html

Prescription Drugs 

The new health care law will help make your Medicare prescription drug coverage (Part D) more affordable.  If you reach the coverage gap in your Medicare Part D coverage, you will receive a 50% discount on brand-name drugs covered by the new Act.  You will continue to receive this discount until you reach the “catastrophic coverage phase.”  For more information please see: http://www.healthcare.gov/law/features/65-older/drug-discounts/index.html

For more information and to read a copy of the law yourself, go to: www.healthcare.gov                                  **All information was taken from www.healthcare.gov                                                                           ***Department of Health and Human Services Press Release: http://www.hhs.gov/news/press/2012pres/07/20120731a.html                                                                         1State of Minnesota. Council on Asian Pacific Minnesotans. State of the Asian Pacific Minnesotans. Jul. 2012. <http://www.capm.state.mn.us/pdf/StateoftheAsianPacificMinnesotans.pdf>.


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Posted by on August 2, 2012 in CAPM news, Community news

 

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