Coventry Health Insurance of Georgia (GA) | Health Insurance Georgia | More Ways the Reform Bill Will Change Health Insurance Georgia Plans

Health Insurance Georgia Reform

More Ways the Reform Bill Will Change Health Insurance Georgia Plans

This is the second article on how the reform bill will change health insurance Georgia plans. To recap, the reform bill is made up of two parts, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010. Both of these parts comprise what is referred to as the Health Reform Acts. There are changes that are mandated to occur in 2010, and others that will become effective at later dates. These changes will be put into effect across the nation, including health insurance Georgia plans. Georgia residents can stay informed of some of the changes that will occur to their health insurance Georgia plans by reading this summary.

A big issue in the health care reform has been that of pre-existing conditions. Health insurance Georgia carriers may deny coverage to someone who has a pre-existing condition because that makes them a high risk member, and will use of a lot of their resources. However, the bill forbids health insurance carriers to deny coverage to someone under the age of 19 for having a pre-existing condition. Not only are they not allowed to deny enrollment in a health insurance Georgia individual plan, but also they cannot impose a pre-existing condition exclusion in respect to their plan coverage. This specifically refers to children's access to health insurance Georgia plans. This mandate is to be in effect on health insurance Georgia plans that start six months after the enactment of the health reform act, which is in September of 2010.

Many of the health reform acts rules place limitations on what health insurance Georgia carriers can exclude or limit. For example, health insurance Georgia carriers will no longer be allowed to set annual limits on the dollar value of benefits in the future for individual health insurance Georgia plans. Currently, many health insurance Georgia policies have lifetime limits, at which time the insurance provider is no longer required to pay out benefits. This will change in the future. However, some limits are still allowed. Health insurance Georgia carriers will be able to set annual limits on services referred to as "essential health benefits", which will be defined by the federal government.

Health Insurance Georgia Plan Will Cover Preventive Services with No Co-Payment

Another additional requirement that the reform acts are placing on health insurance Georgia carriers are requiring their health insurance Georgia plans to cover certain preventive services that will be defined by a task force of the federal government. For now, it is understood that these preventive services covered will include immunizations, preventive care for infants, screenings for women, etc. Health insurance Georgia policies will be required to cover these services without requiring a co-payment from the member. Most health insurance Georgia plans cover all preventive services already, but they are included in the services that require some type of co-insurance from the member. In the future, there will be no co-payment for these specific preventive services medical services, under the new health insurance Georgia plan requirements.

Other changes include regulations regarding the appeals process for health insurance Georgia coverage denials, claims, and exclusions. Many of the new regulations require that health insurance Georgia plan language be easier to understand so that members can make better informed decisions.

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