Tuesday, March 23, 2010

Reform Rx - Real Life Benefits

If you have coverage, insurance that was in effect before the bill becomes law is grandfathered in. Still, some provisions in the sidecar bill, like bans on lifetime benefit caps, would apply even to those plans.
That would solve a big problem for people such as Amy Wilhite of Marblehead, Ohio. Her family is insured through her husband's employer, but her 12-year-old daughter, Taylor, a leukemia survivor, has already gone through more than $1 million of medical care in her life and is approaching a $1.5 million cap. Taylor has been delaying or forgoing some care to stretch out coverage as long as possible.

This change, as well as rules against insurers' yanking policies if you get sick, and forcing family policies to generally include kids up to age 26, takes effect six months after the bill becomes law.

Retiree Daniel O'Connell of Greenville, S.C., said closing the doughnut hole was "very beneficial to me." Mr. O'Connell—who lives on a fixed income of about $40,000 a year—hit the coverage gap in August last year, and said he incurred about $1,500 in out-of-pocket costs.
"At a certain point you're not covered, even though you're paying the premium," he said.
All the above were found in an article in the March 22 Wall Street Journal online titled Steps You Can Take Ahead of Changes in Coverage, Taxes. It was not in the Monday printed edition I received. The Journal editorialized heavily against the legislation and will continue to do so. However it is apparent that once the law is in force that there is a pragmatic real life financial set of benefits that even the Wall Street Journal cannot ignore in their reporting.

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