When will I start to see changes to my health plan because of healthcare reform?
Many of the provisions in the new law won't take effect for several years. Some provisions took effect in September 2010. Most of those early provisions won't affect your plan until it renews. Humana will let you know about any changes before your plan renews.
Do I need to do anything differently, now that healthcare reform is law?
No, you can use your health plan as you normally would.
Will my premium change due to healthcare reform?
In general, it's hard to say how your plan's benefit design and premium rates may change. We need to know more about the law and how state and federal agencies will apply provisions.
Does the new healthcare reform law cover preventive services at no cost?
As part of healthcare reform, and depending on your Humana health plan, a range of preventive services will be available to you at no cost. Contact your agent for a list of services that will be covered 100 percent as part of preventive care. That means no copayments, coinsurance or deductibles when these services are performed by providers in the Humana network. Also, it's important to note that you won't have to pay out-of pocket for these services unless you get them as part of a visit to diagnose, monitor, or treat an illness or injury.
What about "grandfathered" health plans?
Under the new law, the plan you had as of March 23, 2010, is considered a "grandfathered" plan. Such plans are exempt from many - but not all - reforms. New plans, effective after March 23, 2010, are not "grandfathered" and will include various changes. For example, the new law eliminates annual limits on certain key health benefits and requires plans to include a new, mandatory package of "essential benefits." Those benefits may be important for you. They also could make your premiums somewhat more expensive. Only you can decide whether it's best to keep your current, grandfathered plan or move to a new plan. See the healthcare reform timeline for more details.
Important Note: You may lose your rights to a grandfathered plan if you make changes to your current health plan. For example, you could lose grandfathered plan status if you choose a plan that eliminates all or most benefits for a particular condition. Also, you could lose "grandfather" status if you do any of the following without a decrease in premium:
- You switch to a plan that pays a lower coinsurance percentage
- You increase your deductible by more than 18 percent
- You choose a plan with higher copayment
I've read that reform is supposed to lower health care costs. Will HumanaOne members be eligible for any rebates?
Not all of the law's rules and regulations have been released, so it's difficult to understand the full impact of healthcare reform on any
member's specific premiums.
Does the new healthcare reform law provide me with free healthcare coverage?
No. The law does not mean that you're now covered under a free government health plan. Such a change isn't part of healthcare reform. One of the goals of healthcare reform is to create additional health insurance options, whether from private health insurers or expanded public programs like Medicaid.
The law has provisions designed to help low and moderate-income people afford healthcare. Under the law, in 2014, premium assistance for uninsured people with incomes between 133 - 400 percent of the federal poverty level will be available for plans purchased through new, state-run exchanges. The amount of help will depend on your income. The lower your income, the more help you can expect.
Also in 2014, Medicaid will expand to cover people with annual incomes at or below 133 percent of the federal poverty level. That's $29,327 for a family of four. If you think you qualify, the agency that oversees Medicaid in your state likely can give you more information.
As always, you should carefully evaluate your personal situation and insurance options before making any decisions about your healthcare coverage. Only you can make sure you have the healthcare coverage you and your family need and want.
I currently have a HumanaOne health plan and would like to continue coverage for my child who's over 21. Can I do that?
A provision of healthcare reform allows adult children to stay on their parents' plan until their 26th birthday. This provision took effect on September 23, 2010. Adult children can stay on their parents' HumanaOne medical plan until age 31 if coverage isn't available through their job and they aren't married. If the adult child is married, coverage will be available until they reach at least their 26th birthday. In some states, married children can remain on their parents' policy past their 26th birthday. If you have questions about your state, call HumanaOne Customer Care at the toll-free number on the back of your HumanaOne ID card.
I have a HumanaOne plan. Can I add my 21-year-old child to my plan?
HumanaOne will cover adult children up until they reach at least their 26th birthday, as required by healthcare reform. In some states, adult children can be covered by their parents' HumanaOne policy beyond their 26th birthday. Like all applicants for a new policy, the adult child's health history would be reviewed. HumanaOne needs to determine if they qualify for coverage.
I don't have a HumanaOne health plan, but I'd like to have a HumanaOne policy. Can I cover my child who's older than 21 on my HumanaOne plan?
Yes. HumanaOne will cover adult children until their 26th birthday, as required by healthcare reform. In some states, adult children can be covered by their parents' HumanaOne policy beyond their 26th birthday. Like all applicants for a new policy, the adult child's health history would be reviewed. HumanaOne needs to determine if they qualify for coverage.
My family member has a pre-existing condition and isn't eligible for coverage right now. When can they get coverage?
We know that many people are eager to obtain coverage. The new law states that starting in 2014, health plans can't have pre-existing condition limits. The new law also ends pre-existing condition limits for dependent children younger than 19 under certain plans.
Under this provision, insurance companies can't:
- Deny coverage to a child because of a pre-existing condition
- Deny payment for a child's treatment because the treatment is related to a pre-existing condition
This provision will apply to your benefit plan at your next renewal unless otherwise specified. These rules will apply to all types of health insurance, except for individual policies that are "grandfathered."
IMPORTANT: This information applies to health plans only and is intended to provide a general overview of the new health care reform law. It does not attempt to cover all of the law's provisions and should not be used as legal advice.