The rollout of federal health-care reform reaches two more key dates over the next few weeks.
On Sept. 23, insurers and insurance plans must allow children under age 26 to stay on their parents' policy. In some cases, there is an exception for an adult child who has an offer of job-based coverage.
The regulation is expected to cover about 37,300 North Carolinians, according to the U.S. Census Bureau. Some employers and most insurers have agreed to cover adult children immediately.
Stronger consumer protections also come into effect Sept. 23 that will be felt as individuals and families renew or buy coverage.
Those include: no lifetime limits on insurance coverage; no exclusion of children with pre-existing conditions; and an appeal process covering insurers' new health-care plans.
Consumers in new plans will have coverage for recommended preventive services -- such as immunizations, mammograms, well-baby and well-child care -- without having to pay a co-pay, coinsurance or deductible.
On Oct. 1, there will be increased federal financing for the state's 173 community health centers that is projected to nearly double the number of patients getting care over the next five years. There are five centers in the Triad, three in Burlington, and two in Asheboro.
Also on that day, the Affordable Care Act will begin providing $1.5 billion over five years for the National Health Services Corps.
The money will go toward scholarships and loan repayments for doctors, nurses and other health-care professionals who work in areas with a shortage of such personnel.
The four services will be the latest developments in health-care reform.
Among the initial offerings were:
• Closing the Medicare Part D doughnut hole for prescription drug costs.
The government began sending in mid-June a one-time $250 check as Medicare recipients hit the gap. The doughnut hole is reached once a participant has $2,830 in total drug costs. They pay the full cost of prescription drugs until their total out-of-pocket cost reaches $4,550.
More than 23,000 North Carolinians had received the check through early August.
• At least 19 employers with operations in the Triad have qualified for the first round of the Early Retiree Reinsurance Program. Those employers will begin to get reimbursements for employee claims in October.
The program focuses on retirees age 55 and older who are not eligible for Medicare. It is being paid for with $5 billion from the act. An estimated 119,000 early retirees are expected to benefit.
The program was established by Congress in part because critics said that the tax increases levied to finance reform may have convinced many employers to eliminate the benefit.
• 124,000 small businesses may be eligible for a tax credit that lessens the cost of providing coverage.
rcraver@wsjournal.com
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