Health Reform

The Patient Protection and Affordable Care Act that President Obama signed on March 23, 2010, will result in significant changes to health insurance in Idaho.

Some of the changes became effective on September 23, 2010 including a requirement for insurers to extend coverage under the parents' policy to children up to age 26, prohibiting insurers from rescinding health insurance policies except for fraud or intentional misrepresentation,  prohibiting insurers from imposing a preexisting condition waiting period on children under 19, removing lifetime limits and phasing out annual limits on coverage, covering preventive health care services without cost-sharing and other requirements. However, some of the requirements only apply to new issued plans, and some of the requirements will not take effect until your plan renews.

The Idaho Department of Insurance regulates health insurers writing insurance in Idaho and will enforce these requirements.

Which new protections you get depends on how you get your insurance and when you or your employer enrolled in your plan.

Do you buy your own health insurance?

As of January 1, 2011 your individual plan cannot:

• Charge out-of-pocket costs for preventive services. **
• Cap lifetime benefits. (Caps of $1 million or $2 million are now common) **
• Cancel or rescind a policy, except in the case of fraud.
• Refuse to cover a child’s pre-existing condition. **
• Young adults may be covered on their parent’s plan until the age of 26, unless they get a job which offers health insurance.

** If you enrolled in your individual plan before March 23, 2010, your plan is grandfathered and isn’t required to include these benefits.

Do you get health insurance from your employer?

After September 23, 2010, when your plan renews it cannot:

• Charge out-of-pocket costs for preventive services.**
• Cap lifetime benefits. (Caps of $1 million or $2 million are now common)
• Cancel or rescind a policy, except in the case of fraud or misrepresentation.
• Refuse to cover a child’s pre-existing condition.
• Young adults may be covered on their parents’ plan until the age of 26, unless they get a job which offers health insurance.

** If your employer enrolled in its plan before March 23, 2010, your plan is grandfathered and isn’t required to include these benefits.

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