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A health care exchange will be established to assist consumers with ability to buy insurance from a competitive marketplace. The exchange will assist individuals and small businesses with finding affordable and qualified health benefit plans. The exchange will be fully implemented in 2014. This will provide consumers with the ability to compare, understand options, and get the best price according to their needs in one place.
There are many more changes occurring throughout the year and into 2015, for a detailed timeline of the many objectives of federal health care reform please visit www.healthcare.gov. While each and every piece to federal health care reform is very important, there are many that will take more time to ensure effectiveness.
The new Community First Choice Option allows states to offer home and community-based services to disabled people through Medicaid, rather than institutional care in nursing homes.
To ensure insurance companies are spending premium dollars primarily on health care, the new law requires:
That at least 85% of all premium dollars collected by insurance companies for large employer plans to be spent on health care services and health care quality improvement.
That 80% of all premium dollars collected by insurance companies from individual and small employers to be spent on benefits and quality improvement.
If insurance companies do not meet these goals due to administrative costs or profits being too high, then the companies must provide rebates to consumers.
Changes in Medicare:
The law provides certain preventive services, such as annual wellness visits and personalized prevention plans, for seniors on Medicare. Click here for more information.
Seniors who reach the coverage gap (also known as the “donut hole”) in prescription drug plans will receive a 50 percent discount when buying Medicare Part D-covered brand-name prescription drugs. Additional savings on brand-name and generic drugs will be offered until the gap closes permanently in 2020.
Grants were awarded to several states. The purpose of this grant is to set up and expand on programs which will provide better consumer assistance.
The programs will allow the states to develop ways to help consumers by:
Helping consumers file complaints and appeals
Enroll in health coverage
Educate about consumer rights and responsibilities in group health plans or individual health insurance policies
Assist the state in collecting data on the types of problems consumers have