Today, I’m rolling out a series called “10 Health Care Outrages Fixed by Health Care Reform. I wrote this because I didn’t know what was in the big bill the President signed last March – and this was a good way to find out. Having read the contents, I’m actually proud of our government.
Outrage #10: Routine Claim Rejections
Insurance companies keep reimbursements down by rejecting fair claims and then making it difficult for you to fight the rejection.
Solution: Impartial Appeals Process. Health plans have to create impartial initial review and appeals procedures that let you fight coverage rejections. ♣
Outrage #9: Dollar Limits in Care
If you get too sick, you may run out of insurance because of limits on how much health coverage you get over your lifetime.
Solution: No Life Limit. Group plans will not be able to limit lifetime or annual dollar limits on “essential health benefits.” But, this gets phased in, starting at an annual limit of $750,000 to $2 million in 2013.
[box type=”info” border=”full” icon=”♣”]♣ Rules that apply only to new plans. Some mandates only apply to plans that are not grandfathered in, because it was in effect, and unchanged, since March 23, 2010. This symbol indicates a rule that does not apply to grandfathered plans. [/box]