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What is the Patient’s Bill of Rights Act?

Just the essentials...
  • The Patient’s Bill of Rights Act allows people with pre-existing conditions to get affordable health insurance
  • The ACA unfortunately caused health insurance to become more expensive for people
  • There are several advantages and disadvantages of government insurance
  • Private insurance increases choice in your health plan

When you are shopping and comparing insurance plans, you will want to make sure that you understand some of the current laws that apply to insurance. One bill that needs to be analyzed is the Patient’s Bill of Rights Act. It is described below with some tips on how it applies to government insurance plans. This will be followed by looking at the advantages of private insurance and how you can make sure you get the type of coverage you need to fit your budget.

What is the Patient’s Bill of Rights Act?

This is a bill that President Obama announced that included a set of protections applying to health coverage starting on or after September 23, 2020. This was issued six months after the enactment of the Affordable Care Act.

There have been many attempts to create a “one size fits all” type of health insurance that can fit the needs of multiple people. But if you study what these collective plans do, you will see that they tend to help government budgets more than to suit individual health care needs.

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What does the Patient’s Bill of Rights Act mean to me?

When you are considering changing your insurance or need to update your policies, you will want to know how this bill applies to you. The Department of Health and Human Services, along with the Department of Labor and Treasury, collaborated on the Patient’s Bill of Rights Act to allow people with pre-existing conditions to obtain coverage. It supposedly allowed children and adults to end lifetime limits on the amount of length of care that patients receive. The idea behind it was to allow you to keep your doctors and medical care without paying additional costs.

What are pre-existing conditions?

Pre-existing conditions are those conditions that a patient already has before they seek out health insurance. The problem is that many insurance carriers do not offer policies for people with pre-existing conditions. Insurance companies must keep close track of their reserve and keep their claims balanced with their income through premiums.

This is why many of them do not allow certain policies within their health coverage. If they allowed pre-existing conditions for every person who had them, they would go out of business in a short period.

However, many private insurers do allow for some pre-existing conditions as long as they are not terminal. This is why it is important to check and compare between different companies to see where you can get the best rates if you have any pre-existing conditions.

Advantages of Government Insurance

The advantages of government-backed insurance plans like Obamacare under The Affordable Care Act had more to do with premiums than any value in the plan itself. It allowed for a quick solution to younger people, low-income families, and anyone else who did not have health insurance.

This kept them from having to pay the penalty at the end of the income tax year that was instigated during the Obama administration, and provide low-income people with health insurance. But does it help individuals save on their health insurance in the end? Many people found that it didn’t help them at all.

Disadvantages of Government Insurance

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The problem with government insurance is that you are always limited by the specifics of the government plan that you are under. You may be allowed to keep your doctor in certain situations. But, as people are starting to discover, this is not true in every instance.

Many Americans got an unpleasant surprise at the beginning of November that increased their payments on Obamacare up to $2500 more per family or 100 percent increases!

This shows the problem inherent in government-backed insurance. Regardless of the politics involved, government insurance is always going to limit choice of the individual and score instead on the “collective view” of how much money the country saves on their budget, whether it helps individuals are not.

The Advantages of Private Insurance Companies

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The best thing about private insurance companies is that they allow more choices. For example, if you have a need to see a specialist, you can often do this on your own without the consent of your primary care physician.

There are other advantages of private carriers. Private insurance allows you to change doctors and service providers if you are not happy with your current service. It allows you to use your deductible with multiple carriers without having to adhere to some collective standard. It also gives you an individual agent who can answer your questions anytime and give you advice on how to proceed to get the most benefit from your plan.

Shorter Wait Times

Another key advantage to private insurance is that you have shorter wait times. If you have a surgery that is needed, you may be caught up in red tape and paperwork with government insurance for weeks or months. With private carriers, they allow the process to go through faster due to their dedication to individual clients.

Other Options for Private Insurance

If you are under an HMO plan, you would still have to get a referral from your primary doctor. But you also have other options such as PPOs and other delivery models that allow for more flexibility within your private plan.

You should check the specifications of the insurance company you are considering before signing up so that you know what you are getting. It’s always best to ask questions if you are not sure about what you are getting.

HMO vs. PPO Plans

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One thing to keep in mind when shopping for your private insurance plan is that you will need to choose between an HMO or PPO. There are other forms of plans as well, but we will discuss these primarily in this post. An HMO (Health management plan)is designed to lower the costs of your insurance.

The tradeoff is that you will have to stay within your network to use the HMO plan. With a PPO, you can change doctors from outside the network with an additional cost. Talk to your insurance agents as you compare plans and ask what type of model you will be under with their plan.

How to Choose a Private Insurance Plan

If you are wondering what strategy you should use to choose your private insurance carrier, here are a few tips to follow:

  • Choose an insurer that listens to your needs It is important to choose an insurance carrier who listens to your needs. If you have specific questions, you should be able to ask your insurer questions and expect professional answers. Look around and see the ratings of your insurance carrier options before you buy.
  • Look at the pre-existing health conditions information– Do you have any pre-existing conditions? While not all private companies allow for this, many do. It usually depends more on the degree of severity of such pre-existing conditions rather than the fact that you have a pre-existing condition.
  • Amount of premium You can only budget what you can afford. So work on finding an insurance carrier that fits your budget needs. Ask your online advisor or an agent what your options are regarding payment and find a plan that fits both your health and budgeting requirements. Remember that some insurance is always better than none.
  • Coverage limits and exclusions – You will also need to read the “fine print” when comparing and shopping for health insurance. What are the coverage limits and exclusions of the policy you are considering? Remember an agent may not mention this unless you ask. This does not necessarily mean they are avoiding giving you the information. But they are focused on highlighting the benefits of the package. So ask what it does not cover.
  • Claims record – An insurance company’s claims record is important to know how well and in what manner they pay their claims. You can find this information on the

Better Business Bureau’s site or others such as AMBest. These regulatory and review sites are dedicated to keeping you informed as to how companies conduct business.

Tips for Choosing Health Insurance

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When you are shopping for insurance coverage options, there are some tips to keep in mind that will help get you the best rates and coverage that you need. You should always consider all of these things when shopping for your health insurance plan so that you will maximize the advantages you can get from your health plan.

– Consider Your Health Conditions

Think about what your current health conditions and needs are. You will need to find health insurance coverage that will cover your unique health needs, rather than just some blanket plan that will cover general health issues.

It is important that your insurance plan is customized to meet your personal needs as well as those of your family if you are putting them on your plan, as well.

This is where you will need to ask questions before you sign up for a plan so that you will be sure you’ll get the coverage you need.

– Consider Your Prescriptions

One of the most expensive aspects of your health insurance plan is your prescription medications. Check with your insurance provider to see if they cover prescription medications and what the exclusions are. This will become one of the most important parts of your insurance plan and may determine whether or not you will need an additional HSA (Health Savings Account) to save for your prescriptions.

About HSAs

Ask your insurance agent or advisor about HSAs. Health Savings Accounts allow you to create a unique savings account in order to pay for prescription medications. This money will come in handy during times that you cannot afford to pay for your drugs on your own or where your insurance does not pay.

Reminder About Medicare and HSAs

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Keep in mind that Medicare recipients can receive HSA funds up until their 65th birthday. So you can use any funds that were in your HSA account previous to your 65th birthday. After you reach the age of 65, you can no longer save more money for your HSA.

That is why it is more important than ever to have a private supplemental insurance company that can kick in where your Medicare coverage leaves off. For people under 65 who do not qualify for Medicare, supplemental insurance helps you to cover any unexpected or ongoing health insurance costs on your terms.

The best part about individual health insurance is that you have more control over your plan than with any government health plan.

How Politics Affects Insurance

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With the new changes in the U.S. government and a new election behind us, we are likely to see some extreme changes in government based plans that will benefit people in new ways. But another thing it will effect is the private insurance industry.

Private companies are likely to have more business from people who move their plans from government-backed insurance to individual, thus creating a new period of wealth for private insurers which they will pass on to the consumer.

The insurance industry has had many changes over the years. But it is up to you, the consumer, to shop around and compare to get the best deal for your unique health care concerns. It’s your right as an American.

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MULTIPLAN_GHHK5LLEN_Accepted Last Updated 3/18/2018