Adair: What South Carolinians need to know about Affordable Care Act

September 30, 2013 

On Tuesday, open enrollment beings for the Patient Protection and Affordable Care Act. And regardless of what your position on the law, it is just that — a law. A federal one, at that. And trying to gather all the information being disseminated regarding healthcare reform or, as many call it, “Obamacare,” is nothing short of overwhelming.

It is probably the best ever example of the adage about “trying to get a sip of water from a fire hose.” It’s not easy.

With that in mind, here is a manageable trickle of information — in eight broad-rush and factual statements — about just what all the talk is about. In understanding how the Affordable Care Act affects each of us as South Carolinians, we all still need to dig a little deeper — particularly if you have concerns about any of the following statements. But you will at least know where your concerns are and can ask a pointed question or two about specific issues. So, take your time and consider these points which are at the center of what is currently the most visible and divisive issue in America.

• Under the ACA, pre-existing conditions such as asthma, diabetes, Crohn’s Disease, and many more can no longer be used by insurance companies to deny coverage.

• Health care policies on children can no longer exclude coverage for specific illnesses or conditions, such as services for autistic children.

• Children can remain on their parents’ insurance plan until they reach 26 years of age.

• There is a greater emphasis on preventative care such as mammograms, pap smears, vaccinations, colonoscopies, physical exams and more; and the preventive care is free.

• Annual or life-time caps on dollar amounts attributable to treatment expenses for an illness or condition are no longer allowed.

• Insurance companies will no longer be able to drop your coverage if you become ill.

• Seniors will no longer face “the donut hole” in prescription costs that would be imposed once they reach a defined dollar limit in covered prescription costs.

• If you can afford health-care insurance — and you are not covered by an employer policy — you must purchase healthcare insurance or face a fine imposed by the government.

There’s obviously more to all of this as the new law is complex. But for any South Carolinian, these eight points cover many of the fundamental changes that will take place as the Affordable Care Act opens for enrollment Tuesday and is implemented beginning Jan. 1.

John Adair

CEO, HealthAviator.com

Greer

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