Health care reform

Exclusions for Pre-existing Conditions

Because of the ACA, insurance companies are no longer allowed to deny people coverage for having pre-existing conditions. A pre-existing condition is a health condition that someone has before they enroll in an insurance plan.

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  Currently children under the age of 19 cannot be denied health coverage for having a pre-existing condition. (This rule began in 2010.)
  

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  In 2014, people of all ages cannot be denied health coverage for having a
  

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  In 2014, insurance plans cannot charge higher premiums based on health or gender. They may only use family size, age, geography and tobacco use to determine premium rates and these calculations are limited.
  

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  Currently, insurance companies cannot raise premium rates by 10% or more without first explaining their reasons to your state or federal Rate Review Program. (Rate Review Programs help determine if premium increases made by the insurance companies are unreasonable.) Insurance plans have to report their premium rates to the state department that oversees Rate Review.
  

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  Rate Review applies to new plans in the individual and small group markets.
  

Because of the ACA, insurance companies must stop placing limits on how much they pay out in benefits.

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  Currently, insurance companies cannot put lifetime limits on most covered benefits in any health plan. (A lifetime limit is a dollar limit on what a plan would spend for your covered benefits during the entire time you were enrolled in that plan.)
  

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  In 2014, insurance companies cannot put annual limits on most covered benefits. (An annual limit is a dollar limit on how much the plan will spend on your benefits in one year.)
  

Note: The ban on annual limits only pertains to job-related plans and individual health insurance policies. Additionally, plans can put an annual dollar limit and lifetime limit on spending for health care services that are not considered “essential.” To see what are considered “essential” health benefits visit www.healthcare.gov .

Policy Rescissions

Before the ACA, if your insurance company found out you made a mistake on your application they could cancel your policy from the day it began. This is known as “policy rescission.” Now, because of the ACA, insurance companies can no longer cancel your health coverage because of a mistake you made on your application or because you left out insignificant information related to your health.