The health insurance industry has changed rapidly since the new Affordable Care Act law has been introduced and implemented. The design and purpose for this arrangement has been implemented to accomplish several different scenarios. The first purpose is an attempt to control healthcare cost. Health Maintenance Organizations ( HMO) is a network designed to control healthcare cost; a person’s primary physician is their gatekeeper to manage their health and provide low-cost maintenance for individuals in need of healthcare services. Within the network of providers care is provided from medical professionals within a tight knit unit consisting of: hospitals, outpatient surgery facilities, diagnostic centers, certain specialist, and general practitioners to name a few.
Insurers are automatically including preventative care as a feature which is by the way one of ten essential benefits that must be included with every plan sold today; this is an excellence marketing strategy to convince consumers they are getting something for free or at no cost to them. The second reason this new law is good for most people is that for those who were once unable to obtain any health insurance at all; are now able to get coverage. Also, if it was not for this new law, people with pre-existing conditions would have been rated or denied coverage altogether. Those days are over and the way insurance is purchase today is a package deal. Everyone need and deserves to be cared for when experiencing either physical or mental health challenges.
One thing I do not hear consumers acknowledging is the appreciation that their pre-existing conditions are no longer an issue and their medical history is a thing of the past. People want the benefit of being insured, but fail to recognize the good this new act has made possible; who otherwise would have never experienced the possibilities of enjoying affordable health care.
Every health insurance plan beginning in the year of 2014 will include a combination of ten essential benefits which includes the following but not limited to: ambulatory services, hospitalization, laboratory services, maternity, mental health services, prescription medicines, preventative care, and rehabilitative services just to name a few. Under the new law all plans must include all ten essential benefits. The way insurance was purchased in the past; is a thing of the past.
The third reason behind this ACA law is so that people in general would not go completely broke financially with surmounting medical expenses. There is an out of pocket maximum (OOPM) limitation insurers are including in their plans which is another good feature to persuade consumers again to purchase coverage. The way insurers are designing their plans under the new guidelines include: deductibles, co-insurance, and out of pocket maximums for each category of their plans. Any type of insurance helps reduce financial losses.
Going forward will be a one size fits all to a certain degree. For those of you who are financially wealthy, these changes in the law will not have much of an impact on you. However, the benefits of these guidelines will protect your wealth if and when you experience medical cost exceeding your savings and assets; mainly because of the outlay of money limiting your out of pocket maximums; meaning once you reach a certain limit financially out of your own pocket, then your insurer will cover 100% of your medical expenses. As consumers we have to ignore the negative press and realize how important this new law protects our finances and allows anyone regardless of their health conditions to be insured protecting his or her assets over the long haul.