The Affordable Care Act changes many areas of health care, and will significantly impact cancer care.
BENEFITS IF YOU HAVE BEEN DIAGNOSED WITH COLORECTAL CANCER:
- Already in place: Health insurance plans cannot drop you or reduce your benefits just because you become sick.
- After January 1, 2014, insurance plans will not be able to deny coverage or charge higher premiums if you have a pre-existing condition. Until that time, people with pre-existing conditions will be able to find affordable insurance in special high-risk pools supported with federal funds. For people with inherited colorectal cancer who worry about testing for a genetic condition, the law specifically includes genetic information among the health conditions for which there cannot be discrimination.
- Insurance companies can no longer place lifetime limits on healthcare coverage, nor can they impose restrictive annual limits. In 2014, all group and individual plans must eliminate annual limits. Even if you need expensive cancer care, you will no longer need to worry about your insurance refusing to meet those costs.
- Depending on your income, there will be limits on the amount of money you need to pay out-of-pocket for health care for you and for your family each year.
- In 2014, uninsured people will have access to several new options including higher income limits for Medicaid and participation in an American Health Benefit Exchange. The exchanges will clearly outline costs and benefits of each health care policy so consumers can make informed choices about care. Subsidies will be available to keep costs affordable.
BENEFITS IF YOU WANT TO PREVENT COLORECTAL CANCER:
- If you are privately insured through your employer or the insurance exchanges, preventive services are covered fully without your having to meet a deductible or pay a co-pay.
- If you are on Medicare, cost-sharing for preventive screenings ended on January 1, 2011. However, if a polyp is discovered during the screening exam the law provides that the procedure be billed as a diagnostic exam and the patient would have a co-pay. Medicare will also pay for an annual check-up.
- If you are on Medicaid preventive services will be provided at no cost.
OTHER IMPACTS ON COLORECTAL CANCER PREVENTION:
While not specifically addressing colorectal cancer, wellness and prevention of illness are addressed in several new initiatives established and funded by the law including:
- Establishment of a National Prevention, Health Promotion and Public Health Council to coordinate prevention, wellness, and public health strategies.
- Establishment of a Prevention and Public Health Fund to expand and sustain funding for prevention and public health programs, as well as task forces on Preventive Services and Community Preventive Services to develop, update, and disseminate evidenced-based recommendations on the use of clinical and community prevention services.
- Grants to support evidence-based community prevention and wellness programs that strengthen prevention activities, reduce chronic disease rates and address health disparities, especially in rural and frontier areas. Funding for five years beginning in FY 2010.
Trained caseworkers in the Office of Consumer Support in the Center for Consumer Information and Insurance Oversight can help you find and enroll in a health plan that meets your needs and to appeal when your insurer denies a claim for covered benefits. The program can also help you understand your legal rights and options when you’re losing health insurance. Click on the button below for more information.