Review Note

Last Update: 07/22/2024 01:49 PM

Current Deck: C2P

Published

Currently Published Content


Front
Describe the current protections for people with pre-existing conditions regarding
access to health insurance.
Back
·       Guaranteed Coverage: Under ACA, health insurance companies cannot refuse to cover individuals or charge them more due to preexisting conditions
·       No premium discrimination: Insurers cannot charge higher premiums based on indiv. health status; only can for age, tobacco use, family size, and geographic location
·       No exclusions: insurers and employer group plans cannot refuse to cover services needed to treat pre-existing conditions
·       Essential Health benefits: Insurers must cover 10 essential benefits
·       Prohibition if lifetime and annual limits: insurers cannot impose lifetime or annual dollar limits on coverage for essential health benefits
·       Pregnancy: considered a preexisting condition and must be covered from the day the insurance plan starts
·       State-level protections: some states have additional laws, 10 states have adopted all four ACA protections, 15 have adopted at least one
o   Texas has adopted none. 
o   Medicaid + CHIP: cannot refuse coverage or charge more for preexisting conditions

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