Posted on February 3, 2011 11:45
Categories: Medicaid | Medicare | Prevention and Wellness
Topics: Employer-Sponsored Coverage | Individual Coverage | Medicaid | Medicare | Out-of-Pocket | Prevention
On December 28, Health Affairs released a brief examining the national health care reform law’s preventive health services provisions. The brief explains that the law requires insurers to provide certain preventive services at no cost to beneficiaries, and outlines how the change alters benefits in private health plans, Medicare, and Medicaid. The authors suggest that the law increases access to preventive services, helping patients who previously paid for those services out-of-pocket. The brief also estimates that the impact of increased preventive service utilization will grow as more health plans lose their protected “grandfathered” status.
From the brief:
The Affordable Care Act requires new private health insurance plans to fully cover the costs of 45 recommended preventive services as of September 23, 2010. This means patients pay no deductibles or copayments or otherwise share costs of these services. As of January 1, 2011, the health care law also requires coverage for a new annual wellness visit under Medicare and eliminates cost sharing for recommended preventive services covered by that federal program.
The law also gives state Medicaid programs financial incentives to cover preventive services for adults and supports initiatives to improve public understanding of the benefits of lifetime preventive services. This brief examines the importance of preventive services, the expansion of access to those services required by the new law, and the pros and cons of expanding access to screenings and other tests that might increase costs without necessarily improving health outcomes.
Full Brief: Preventive Services Without Cost Sharing
Health Affairs. (2010). Preventive services without cost sharing.
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