Investigate funding options for medical care
Most Americans who have health coverage are enrolled in private health plans. The majority get this coverage through their employer, but some have to buy coverage on their own in the individual market. Beginning in 2014, Maryland will offer a Health Care Exchange for purchasing insurance. The Exchange will offer an “Essential Benefits Plan” – items that must be covered. Explore if your private insurance has case managers to help you navigate your insurance coverage.
Never assume a service won’t be covered.
Some of the immediate changes that went into effect with the Affordable Patient Care Act (Health Care Reform):
- Extends dependent coverage for adult children up to age 26 for all individual and group policies. Plan or policy years beginning on or after September 23, 2010.
- No Pre-existing Conditions – Insurance companies cannot exclude you or a family member from coverage due to a pre-existing condition.
- Creates a state option to provide Medicaid coverage to childless adults with incomes up to 133% of the federal poverty level. (States will be required to provide this coverage in 2014.)
- Small businesses will receive tax credits to offer insurance to their employees.
- Requires new health plans to provide free (no copays) for certain preventive services such as, recommended immunizations, preventive care for infants, children, and adolescents, and additional preventive care and screenings for women. Plan or policy years beginning on or after September 23, 2010
- Closing the Donut Hole – Requires pharmaceutical manufacturers to provide a 50% discount on brand-name prescriptions filled in the Medicare Part D coverage gap beginning January 1, 2011 and phasing-in federal subsidies for generic prescriptions filled in the Medicare Part D coverage gap.
- Establishes a national, voluntary insurance program for purchasing community living assistance services and supports (CLASS program).
- Health Savings Accounts – As of January 1, 2011 – Excludes the costs for over-the-counter drugs not prescribed by a doctor from being reimbursed through a Health Reimbursement Account or health Flexible Spending.
Children’s Medical Services Program
Children’s Medical Services, also called CMS, is a program of the Maryland Department of Health and Mental Hygiene. CMS can help low-income, uninsured or underinsured Marylanders ages 0-21 years get specialty care for a chronic illness or disability by paying for needed services.
Possibilities: A Financial Resource for Parents of Children with Disabilities
Introduction to Your Health Care (Your Medical Coverage; Government Health Care Assistance Programs; The Issue of Medical Privacy; Family to Family Health Information Centers)