A.

Many of the prominent provisions of The Patient Protection and Affordable Care Act will not take effect until January 1, 2014. However, significant changes occurred in 2010 and 2011. Here’s a summary with highlights:

June 2010:

• People with pre-existing conditions who have been uninsured for 6 months or more are able to purchase insurance coverage through the Pre-Existing Condition Insurance Plan. Some people may also be eligible for subsidized premiums.

September 2010:

• Existing insurance plans are barred from imposing lifetime limits on coverage. Annual limits on coverage will end in January 2014.
• Insurers are prevented from canceling coverage retroactively (for example, if the policy holder gets sick).
• Insurers are allowed to exclude coverage of pre-existing medical conditions for children under age 19.
• Dependent children are able to remain on their parents' health insurance until the age of 26.
• Medicare recipients who are in the Part D “doughnut hole” receive a $250 rebate.
• All new insurance policies must cover certain preventive screenings, such as breast, cervical, and colorectal cancer screenings, as well as flu shots and immunizations, without charging a deductible, co-pay or co-insurance. *Please note that diagnostic screenings are not covered under this provision.
• Generics are approved within 12 years of patent.
• More funding is available to compare the effectiveness of medical treatments.
• A new division, the Federal Coordinated Health Care Office, improves coordination of care for those who receive both Medicare and Medicaid.

During 2011:

• Medicare recipients who are in the Part D “doughnut hole” receive a reduction in cost of 50% on brand-name drugs.
• Certain types of preventive care are available to Medicare and Medicaid recipients at no cost.

Looking forward to 2014:

• Insurers will not be able to refuse coverage to anyone with a pre-existing condition.
• State-run insurance “exchanges” will offer insurance policies to people who don’t get their coverage through an employer or a government- subsidized program. Those who buy insurance through an exchange and have low-to-moderate incomes will be eligible for subsidies to pay for their premiums.
• More people will be eligible for Medicaid.
• Most (but not all) people will be mandated to have coverage, and a penalty will apply if you don’t.
• All new plans must offer an essential benefits package, including coverage for hospitalization, doctor visits, laboratory services, and medications, with limits on your out-of pocket costs.

Other comprehensive sources of information include The Kaiser Family Foundation and The Medicare Rights Center. Healthcare.gov is the federal government’s consumer-friendly website providing more details on health care reform, as well as current and future coverage options.