Family Health Care Facts


Since the 2010 passing of the Patient Protection and Affordable Care Act (widely known as Obamacare), rumors have swirled about exactly how the legislation will affect Americans.

How to Shop for an Insurance Company
“You want the insurance company to have a good reputation for being fair to its customers,” says Field. “Policies will be standardized, so also look at the network of doctors and hospitals they cover” to make sure your family’s practitioners are on the list.

“I don’t think people understand that the heart of the law is guaranteed coverage,” says Robert Field, a Drexel University professor of law and health management/policy. “Up until now, many people have been unable to get health insurance or have risked bankruptcy to get it.”

Open enrollment in the Health Insurance Marketplace, where people can receive information about the health care plans available to them based on their area and income, begins on October 1. On January 1, 2014, the legislation’s official rollout date, all Americans will gain access to coverage scaled in price to what they can afford to spend. So now is the right time to brush up on the family-related facts parents (who no doubt lack the time to read almost 20,000 pages of healthcare regulations) should know.

  • Physical exams, hearing and vision screenings, immunizations and other “well” doctor’s visits will no longer necessitate a copay or deductible. This benefit extends to grandfathered insurance plans in which at least one family member was enrolled before March 23, 2010.
  • Children under the age of 19 cannot be classified as having a pre-existing condition, be it asthma or diabetes or a birth defect.
  • Children can stay on their parents’ insurance until age 26, seven years past the previously accepted cutoff of 19, even if they are married or eligible for employer-enrolled health care. This change will positively affect an estimated 3.1 million young adults.
  • Government funding is now available for nurses to visit the homes of women expecting a child, providing further support and education for soon-to-be parents.
  • Employers must give nursing mothers privacy to pump milk, providing “a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public.”
  • The FDA has greater flexibility to approve generic drugs, so families can purchase prescriptions at a lower cost without sacrificing treatment.
  • Insurance companies can no longer turn down a claim without an appeal process, giving families legal standing to fight any claim denial.
  • All new insurance plans must provide Bright Futures, the American Academy of Pediatrics (AAP) standard for pediatric care. Benefits include “medically necessary services for children, including physical exams, immunizations, hearing and vision screenings, and developmental and behavioral screenings.”

“Some of the most vulnerable children will have better access to vital health services, age-appropriate benefits and health insurance coverage,” says O. Marion Burton, MD, AAP past president. “The Affordable Care Act recognizes the value of preventive care by saving our health care system money over the long run and by helping our children grow into healthy, productive adults.”

For further info on how the ACA will affect families, click here.

Tim Rattray contributed to the reporting of this article.


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