In a Florida Matters show first aired Tuesday night on WUSF 89.7 FM, a panel of experts answers reader and listener questions about the Affordable Care Act.
Our panel includes Health News Florida Editor Carol Gentry, attorney Linda Fleming of Carlton Field Jorden Burt in Tampa and Jodi Ray, program director of Florida Covering Kids & Families.
Here is a preview of some of the questions, starting with a call from Diane Wood in Hudson:
"My question is about the new provision against denying coverage for preexisting conditions. A person may select a low cost plan which features limited coverage and high co-pays because the lower premiums and their personal history of good health seems to make that a good fit. If that person eventually develops a serious medical condition, could that person, on the next year in open enrollment, choose to change to a higher fee plan which has more comprehensive coverage without experiencing discrimination or denial based on the new preexisting condition?"
CARSON COOPER: Alright, Jodi Ray, what about that? I always heard that you can’t deny anyone for a preexisting condition no matter what?
JODI RAY: Right. That is one of the provisions of the health care law that kicked in, and that kicked in early for children and now applies to everyone. All the health plans, I think it needs to be clear, have a set of essential basic requirements that they have to provide coverage for anyway for everyone, so the plans all have a set of at least 10 different items that they cover on all individuals in all plans. In addition, during an open enrollment period, an individual can change their plan, and the preexisting condition issue still does not apply. They cannot be denied coverage and their premium is not based on their preexisting condition.
COOPER: Now, a number of folks with questions did not want to appear on tape with us or give their names, like this person, a woman whom we met recently at Curtis Hixon Park in Tampa. And she asks, and this is about the requirement to have coverage, wondering if the requirement applies to 18-year-olds so she can take her son off her plan? Sounds like somebody wants to push somebody out of the nest a little early. Obviously, a person, an offspring, can be covered up to the age of 26. What about that, Linda Fleming?
LINDA FLEMING: Since he’s an adult, he’s 18, he’s responsible for his own coverage. So really, it becomes a money decision. If both parents are working and they’re covered under their employer plans, it may not be that much to keep him on the plan, so it really is a matter of economics and figuring out which way makes the most sense to go, even if he is employed and could potentially be covered under his own employer’s plan.
COOPER: So if a parent chooses not to cover their adult age kids, that’s their prerogative?
RAY: Eighteen-year-olds still get coverage in Florida under CHIP, which is the Children’s Health Insurance Program. Florida KidCare covers kids until they turn 19. So depending on the income and the cost to insure him on her plan, may qualify him for coverage under CHIP, so that is a factor that needs to be considered by the mom.
COOPER: So it sounds like if you want to kick your kid off your plan, you’re going to be able to do it.
Here’s a question from Tamina Johnson, age 29:
“I like to travel, and I travel for conferences, and I need to know, am I going to be covered when I go out of state if something was to happen?"
RAY: Some of the plans have national networks, national provider networks, so when they’re picking their plans if this is an issue, and this is important to a family, they may want to look at whether the plans are offering a national provider network, so they have access to a provider if they travel a lot.
More questions and answers on Florida Matters tonight at 6:30 p.m. on WUSF 89.7 FM in the Tampa Bay area; stream online from anywhere by clicking on “Listen Live” at the top left corner of this page.
More resources to help you understand the Affordable Care Act:
- The federal government’s website HealthCare.gov
- Find a navigator or in-person assister: localhelp.healthcare.gov
- Coverage from Health News Florida
