Reform Bill

What the Healthcare Reform Bill Means for You (Continued)

As of 2010...

  • If you have a pre-existing medical condition – including type 1 or type 2 diabetes – and have been uninsured for at least six months, you may be eligible for a new federally subsidized, high-risk insurance pool until 2014, when private health insurance exchanges will become available. The maximum annual out-of-pocket costs will be $5,950 for individuals and $11,900 for a family.
  • Seniors on Medicare's Part D prescription drug plan who land in the "doughnut hole" (reimbursements stop after the first $2,830 and don't resume until costs reach $6,440) will get a rebate up to $250 this year. In 2011, they will receive a 50 percent discount on brand name drugs, and by 2020 the hole will be completely closed. (Next year, Medicare also will pay 100 percent of the cost for an annual checkup, vaccines, and screening tests.)
  • Lifetime or annual limits on benefit payments will be eliminated. This can be critical for people with diabetes, who on average spend twice as much on healthcare as people who don't have the disease.
  • Children with pre-existing conditions can no longer be denied insurance coverage.
  • Young adults can remain on a parent's individual or group insurance plan until they turn 26. The rule does not apply to employer-sponsored plans if the child's job offers health insurance.
  • Deductibles and co-payments for many preventative services and screenings will be eliminated. This may help curb the increase in type 2 diabetes and thereby reduce U.S. health care costs, according to the ADA, including $112 billion spent annually on diabetes treatment.
  • Insurance companies will no longer be able to drop policyholders who get sick and start filing expensive claims.

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Last Modified Date: June 13, 2013

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