"Preventive Services Coverage" Mandate Effective 9/23/2010.

[GreenSky]

I'm very sad to see that Korean Massage Parlors didn't make the list.

But many of the bath houses in West Hollywood would be considered necessary preventive care.

I'll know more in about 45 days and report back.

Rick

 

[VolAgent]

The exact same policies that are being sold with September 1st effective dates can be sold with October 1st effective dates. The big difference will be that the policies that are effective 10/1/2010 will have a ton of free wellness benefits included for the entire family. I call that a sales opportunity, HealthGuy. Agreed?
-A.C.

I thought that this went into effect on Sept 23 for all plans sold since the bill passed? That if a plan was bought in July, on Sept 23 free preventive care was included for it as well? If so, they should have priced in the preventive care back at the beginning of summer, not waiting for plans effective 10/1.

 

[IndividualHealthGuy]

The Colonoscopy IS covered under this mandate. Scroll to the bottom of the Preventive Services webpage and you'll see a link that takes you to the page that explains all the mandated wellness tests. Here's an excerpt from the "Screening for Colorectal Cancer" paragraph:

"The USPSTF recommends screening for colorectal cancer (CRC) using fecal occult blood testing, sigmoidoscopy, or colonoscopy, in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary."

If the colonoscopy is free, I would opt for that over the other tests. As is often the case, the devil is in the details.

Also, immunizations for children cost a bundle here in Illinois, which is why most individual plans put a $300 annual cap on this benefit.

This graphic illustrates the recommended immunizations for children.
http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2010/10_0-6yrs-schedule-pr.pdf

Additionally, in Illinois, several of them are required before a child can enter school. Each of the required immunizations are in excess of $300. They will now be FREE with policies that have an October 1st or later effective date.

This will be some exciting new material to put forth at the next sales meeting... "Educate the public and sell sell sell, before the insurance companies figure things out!"
-A.C.

I'm amazed that in the land that begot Obama to the rest of the world you don't already have coverage for all these things. In both MO and KS immunizations for kids are covered up to age 6 at no patient cost, and have been for years.

Also, I don't see the colonoscopy as the "screening" method here. The fecal occult blood testing is considered a screening service. If there are any signs of abnormality in that, then a colonoscopy is performed. Which, after an abnormal test, would not be considered routine or preventative due to the medical diagnosis code on the claim, and subject to ded/coins or copay.

 

[Crabcake Johnny]

I'd like to see stats on how many men even get an annual physicals. Women - yes; OB/GYN and over 45 - mammogram. I'd even like to see stats on how many women see their OB once a year.

I've read the chart of preventative services that need to be covered. Question is, when was the last time anyone here asked for even a fraction of those services?

 

[HealthGuy]

The problem with this is now the young people dont get a choice. They dont use preventative (especially males) anyway now they have to pay more for just a simple medical plan. I truly think this will raise the pricing on this stuff more than 2%. Obamas "change" means less choice and higher prices. Think of all the idoit young people who voted for this clown. Now Obama is going to make them pay dearly and force them to buy coverage. I love the irony of all of this. Its comical. Vote for a clown and you enter his three ring circus.

 

[somarco]

sad to see that Korean Massage Parlors didn't make the list

Ineffective lobbying.

"Screening for Colorectal Cancer" paragraph:

"The USPSTF recommends screening for colorectal cancer (CRC) using fecal occult blood testing, sigmoidoscopy, or colonoscopy, in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary."

If the colonoscopy is free, I would opt for that over the other tests.

It is an either or "mandate". Also a Grade B (whatever that means) and went into effect in Oct, 2008.

At the top of that page it says these screenings are RECOMMENDED, but not mandated.

You will not see "free" sigmoidoscopy's or colonoscopy's without a fight or a larger adjustment to premiums.

And just because they may be free, I don't expect to see folks flooding doc offices asking for the silver bullet.

"Educate the public and sell sell sell, before the insurance companies figure things out!"

They carriers are not dumb, but the folks who wrote these laws are, as well as those who voted them in to office.

I thought that this went into effect on Sept 23 for all plans sold since the bill passed? That if a plan was bought in July, on Sept 23 free preventive care was included for it as well?

Some carriers have taken that stance, but like other things in the law, are waiting on HHS to clarify.

Of course HHS hasn't read the law . . .

 

[stuy119]

So how does this work in HSA/HDHP plans, where the member is responsible for the deductible PRIOR to the plan paying out?

 

[DS4]

So how does this work in HSA/HDHP plans, where the member is responsible for the deductible PRIOR to the plan paying out?

Internal Revenue Bulletin:

April 12, 2004

Health Savings Accounts—Preventive Care
This notice provides a safe harbor for preventive care benefits allowed to be provided by a high deductible health plan (HDHP) without satisfying the minimum deductible under section 223(c)(2) of the Internal Revenue Code.

 

[Dave020]

1. Lumnenos HSA plans (and a few others) have provided this benefit for no cost for years now. No big deal. It is allowed.

2. 9/23 is not a hard date for these changes. Carriers can use 9/23 OR IFP portfolio renewal period to make the changes. Some carriers in CA will go 9/23, some will wait until the next renewal cycle. PPACA allows either one.

 

[jbage007]

How in the heck are health insurance companies going to be able to afford paying for all these services at 100% with no Co-pay required by the insured?!?!

"They" won't. Their policyholders will.

That's pretty much the way it's always worked.

A mundane fact that somehow seems to escape the big shots in Washington.