---
title: "MBR Explains: Coverage - Key Features of the Affordable Care Act by Year -- 2010"
description: The Patient Protection and Affordable Care Act was signed by President Obama on March 23, 2010. The law aims to increase the quality and affordabilit
image: https://www.mbrbilling.com/hs-fs/file-382810338-gif/images/preexisting_conditions.gif
---

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# Medical Billing Blog

# MBR Explains: Coverage - Key Features of the Affordable Care Act by Year -- 2010

Posted by [Scott Shatzman](https://www.mbrbilling.com/blog/author/scott-shatzman) on Tue, Nov, 19, 2013 @ 10:11 AM

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![Preexisting conditions](https://www.mbrbilling.com/hs-fs/file-382810338-gif/images/preexisting_conditions.gif?width=229&height=193&name=preexisting_conditions.gif)

 

The Patient Protection and Affordable Care Act was signed by President Obama on March 23, 2010. The law aims to increase the quality and affordability of health insurance, lower the uninsured rate, and reduce the costs of healthcare for individuals and the government. However, a number of the mechanisms – mandates, subsidies, and insurance exchanges – are to be rolled out over four years and beyond. Below is an overview of some of the key *coverage *provisions that took effect in 2010.

 

Coverage:

 

- Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition

On October 1, 2010, Sally purchased a new individual health policy for herself and her 13-year-old child, Miranda, who has been treated for asthma in the past. The new health policy excludes coverage for treatment of pre-existing conditions for all enrollees. On November 1, 2010 — one month after coverage began for Sally and Miranda—Miranda is hospitalized for an asthma attack. Her insurance company denies payment for the hospitalization, because under the policy Miranda’s asthma is considered a pre-existing condition.  
**

*Under the new law, the insurer can’t deny payment for the hospitalization based on Miranda’s pre-existing asthma condition. Miranda is under the age of 19. Sally’s policy is new and therefore subject to the pre-existing condition rules of the new health care law. Sally’s policy year began after September 23, 2010, when the law’s rules on pre-existing conditions took effect.*

 

- If you are under 26 years old, you may be eligible to be covered by your parent’s health plan.

 

- States will be able to receive federal matching funds for covering more people on Medicaid. When states cover additional low income individuals and families under Medicaid, the federal government will bear some of the cost.

 

- Insurers can no longer cancel your coverage just because you made an honest mistake.

Example: When her insurance application asked for “anything else relevant to your health that we should know about,” Katy forgot to mention two visits to a psychologist she had 6 years earlier. Katy was later diagnosed with breast cancer, and submitted claims to her insurance company for breast cancer treatment. After receiving Katy’s claim, her plan discovered the two psychologist visits. Before the new law, Katy’s mistake might have prompted her health insurer to rescind, or retroactively cancel, her coverage. But under the health care law, Katy’s insurance plan cannot rescind her coverage, because Katy did not intentionally misrepresent significant information.

 

- You have the right to ask that your plan reconsider its denial of payment

 

- Under the law, insurance companies are no longer allowed to impose lifetime dollar limits on *essential* benefits.

Not only did many health plans set an annual limit, but many plans also set a lifetime limit – a dollar amount on what they would spend for your covered benefits during the entire time you were enrolled in that plan. You were required to pay the cost of all care exceeding those limits.

Under the law, lifetime limits on most benefits are prohibited in any health plan or insurance policy issued or renewed on or after September 23, 2010.

There will be no annual dollar limits on most covered benefits beginning January 1, 2014.

 

- Not all Americans retire at 65. If an individual decides to retire before they are eligible for Medicare, they can see their life savings disappear because of the high rates in the individual market. The PP-ACA creates a $5 billion program to provide financial help for employment-based plans to continue to provide valuable coverage to people who retire between the ages of 55 and 65. This includes their spouses and dependents.

In 1988, 66 percent of large firms provided health care coverage to their retirees. 20 years later in 2008, the percent of firms offering coverage to retirees plummeted to 31 percent. The lack of coverage from their employer forces many retirees to pay exorbitant premiums or simply go without health insurance.

 

Additional information can be found at the U.S. Department of Health and Human Services website: www.hhs.gov/healthcare

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