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Patient's Bill Of Rights Implements New Consumer Protections

  • Published: 2010-09-29 : Author: Congressional Documents and Publications
  • Synopsis: Patients Bill of Rights addresses insurance company abuse while providing the stability and flexibility that individuals and families need.

Main Document

Over 296,000 people in the 27th Congressional District of Texas benefit from The Affordable Care Act.

U.S. Representative Solomon P. Ortiz (D-Texas) announces key patient protection provisions that go into effect 23-09-2010. The Patient's Bill of Rights addresses decades of insurance company abuses while providing the stability and flexibility that individuals and families need to make the choices that work best for them.

Starting today, your insurance company will no longer be able to drop your coverage in the event you get sick. No longer can your child be denied insurance coverage if he or she is born with an illness, disability, or any other pre-existing condition. And the limit that insurance companies often place on lifetime benefits will be prohibited.

"Today we begin a new era of health care for Americans," Ortiz said. "Pre-existing conditions, insurance caps and children being denied health care are issues of the past. The days when your family could be plunged into devastating medical debt and bankruptcy because of a serious medical condition are becoming history. In the 27th Congressional District of Texas, more than 296,000 will benefit from this law - that's more than two thirds of the people I represent."

If these protections are repealed, Americans will once again be at risk of being dropped, denied or discriminated against. Fortunately, the Affordable Care Act now protects working families from the worst practices we've grown accustomed to in health care and is putting patients not insurance executives or bureaucrats in control of our own health care.

Today, September 23, 2010, Americans with private health insurance will now enjoy the following rights:

YOU CAN NO LONGER LOSE YOUR COVERAGE WHEN YOU GET SICK

Before health care reform, insurance companies were able to retroactively cancel your policy when you became sick. Known as a "rescission," this practice plunged many responsible families who had paid their premiums into mountains of medical debt with little recourse to fight back. Today, your health coverage is protected and cannot be "rescinded" when you need it most.

YOUR CHILD CAN GET COVERAGE REGARDLESS OF MEDICAL CONDITION

Until now, children who are born with or develop an illness could be denied coverage by insurers for having a "pre-existing condition." Those uninsured children were much less likely to get critical preventive care, including immunizations and checkups, than their peers. The health care reform law prohibits this practice now every child born in America has equal access to the health insurance market.

YOUR ADULT CHILD CAN STAY ON YOUR PLAN UNTIL AGE 26

One in three young adults has no health insurance because young adults are less likely to have jobs that offer health coverage or they do not yet make enough money to pay their premiums. Under the new law, all insurance companies are required to allow adult children to remain on their parents' insurance plan until age 26.

NO MORE ANNUAL OR LIFETIME LIMITS ON YOUR COVERAGE

You might think it will never happen to your family. You are struck with a life-threatening illness or injury that requires expensive and long-term treatment. Did you know that, before health care reform, your insurance company could put an annual or lifetime cap on how much treatment they cover? Starting today, lifetime caps are outlawed. And over the next three years annual limits will be phased out, starting at $750,000 this year.

PREVENTIVE SERVICES WITHOUT DEDUCTIBLE OR CO-PAYMENTS

Many Americans do not get quality preventive care that can help with early detection of many ailments or diseases. That means fewer individuals have had the opportunity to delay the onset of disease. Under this law, insurance companies must cover recommended preventive services, including mammograms, colonoscopies, immunizations, and pre-natal and new baby care, without charging deductibles, co-payments or co-insurance.

RIGHT TO BOTH AN INTERNAL AND EXTERNAL APPEAL

Today, if your health plan tells you it won't cover a treatment your doctor recommends, or it refuses to pay the bill for your child's last trip to the emergency room, you may not know where to turn. Today, you will be guaranteed the right to an "internal appeal" and insurance companies will be prohibited from denying coverage for needed care without a chance to appeal to an independent third party.

RIGHT TO CHOOSE YOUR OWN DOCTOR

Being able to choose and keep your doctor is highly valued by Americans. Yet, insurance companies don't always make it easy to see the provider you choose. One survey found that three-fourths of the OB-GYNs reported that patients needed to return to their primary care physicians for permission to get follow-up care. The new law: 1) guarantees you get to choose your primary care doctor; 2) allows you to choose a pediatrician as your child's primary care doctor; and 3) gives women the right to see an OB-GYN without having to obtain a referral first.

Visit HealthCare.Gov to learn more about the Patients' Bill of Rights and other provisions of the Affordable Care Act.

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