The Affordable Care Act: What’s in Place Now

A work in progress.

That’s one way to think of the Affordable Care Act (ACA), the health care reform legislation that was signed into law in 2010.

The ACA was passed in an effort to reduce the number of Americans without health insurance and decrease overall health care costs. In many ways, it’s reshaping our health care system and offering people significant benefits.

Some provisions of the law won’t take effect until later. But many are in place today. Here are some key aspects of the ACA that you or members of your family could be benefiting from right now.

Are you currently covered by a health plan?

You may qualify for certain preventive care, such as routine vaccinations, blood pressure checks and cancer screenings (including mammograms and colonoscopies) with no co-payment or deductible.

You are no longer subject to lifetime limits on essential benefits. Annual limits on coverage cannot be less than $2 million in 2013, and by 2014, they will be eliminated.

• Your coverage cannot be dropped if you get seriously ill.

• You’ll be offered rebates if your insurance plan’s administrative costs or profits are too high.

Have you been denied health coverage because of a pre-existing condition?

• New coverage options have been established.

Do you have children?

• Your health plan must offer well-child visits at no cost from birth to age 21.

• Children younger than 19 cannot be denied coverage due to a pre-existing condition.

• Your adult children who have no coverage of their own may be able to stay on your health care plan through age 26.

Are you currently on Medicare?

• You’re entitled to certain free preventive services, such as annual wellness visits and personalized prevention plans.

• If you hit the coverage gap in your prescription drug plan—often called the doughnut hole—you’ll receive discounts on your medication.

Looking ahead

There are other things in the law that may improve your health and your access to health care as well. For instance, officials are investing in prevention and public health efforts, working to increase the number of primary care providers, and strengthening community health centers. And more beneficial changes are coming.

Keep in mind that when your plan took effect may make a difference in your specific benefits.

If you have questions about what the ACA means for you and your coverage, check with your health plan, the Centegra Health & Wellness Network or visit www.healthcare.gov.

Sources: American Academy of Family Physicians; U.S. Department of Health and Human Services