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The 2010 Affordable Care Act puts in place comprehensive health insurance reforms that will roll out over several years. Most changes will take effect by 2014; a timeline of the provisions is available. The law is intended to lower health care costs, provide more health care choices, and enhance the quality of health care for all Americans. Major provisions affecting consumers include:
For more information about the new law, go to healthcare.gov.
Many consumers have health care coverage from their employer. Others have medical care paid through a government program such as Medicare, Medicaid, or the Veterans Administration.
If you have lost your group coverage from an employer as the result of unemployment, death, divorce, or loss of "dependent child" status, you may be able to continue your coverage temporarily under the Consolidated Omnibus Budget Reconciliation Act (COBRA). You, not the employer, pay for this coverage. When one of these events occurs, you must be given at least 60 days to decide whether you wish to purchase the coverage.
Some states offer an insurance pool to residents who are unable to obtain coverage because of a health condition. To find out if a pool is available in your state, check with your state department of insurance.
There are also health insurance programs for people who are seniors, disabled, or have low incomes.
Most states also offer free or low-cost coverage for children who do not have health insurance. Visit insurekidsnow.gov or call 1-877-KIDS-NOW (543-7669) for more information.
When purchasing health insurance, your choices will typically fall into one of three categories:
WARNING: If you go outside the HMO or PPO network of providers, you may have to pay a portion or all of the costs.
When choosing among different health care plans, you'll need to read the fine print and ask lots of questions, such as:
If your health insurer has denied coverage for medical care you received you have a right to appeal the claim and ask that the company reverse that decision. You can be your own health care advocate. Here's what you can do:
Step 1: Review your policy and explanation of benefits.
Step 2: Contact your insurer and keep detailed records of your contacts (copies of letters, time and date of conversations).
Step 3: Request documentation from your doctor or employer to support your case.
Step 4: Write a formal complaint letter explaining what care was denied and why you are appealing through use of the company's internal review process.
Step 5: If the internal appeal is not granted through step 4, file a claim with your state's insurance department.
Page Last Reviewed or Updated: May 16, 2013