• The extension of young adult coverage. This allows adult children to remain on their parents’ plans until age 26, regardless of the children’s marital status or income. The adult children cannot have access to health insurance through an employer.
• A ban on coverage exclusions for children with pre-existing conditions. A similar ban on exclusions for adults will go into effect in 2014.
• The elimination of lifetime caps on benefits.
• Restriction on annual dollar coverage limits. In general, employers cannot impose coverage limits of less than $750,000 for essential health benefits such as hospital services, prescription drugs, emergency services, and maternity/newborn care. The maximum limits increase every year, and they are eliminated in 2014. These limits also apply to new individual policies.
• Additional provisions take effect on or after Sept. 23 for new plans offered by employers or purchased by individuals since March 23. These include requirements that insurers:
  • Cover the full cost of preventive services that have the highest recommendation of the U.S. Preventive Services Task Force
  • Allow women to see an OB-GYN without a referral, and
  • Do not make plan members pay higher co-payments or coinsurance for out-of-network emergency services.

For more information about the provisions that take effect for plan years beginning on or after September 23, visit www.HealthCare.gov. This web site is available to help you find out which private insurance plans, public programs and community services are available to you. An interactive timeline shows the key provisions and changes under Affordable Care Act and when each change goes into effect.

The Pre-Existing Condition Insurance Plan (PCIP) is the high-risk pool plan that you may have read or heard about. The PCIP was created to make health insurance available to you if you have had a problem getting insurance due to a pre-existing medical condition. People covered under PCIP will have access to a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. Under PCIP, you will not be charged higher premium just because of your medical condition, and enrollment in PCIP is not based on income.

Like a number of other states, Virginia is participating in the federally-sponsored PCIP program. As of July 1, 2010, residents of Virginia can enroll in the PCIP. For more information about the PCIP and to apply for coverage through the program, visit the PCIP web site at http://www.pcip.gov/. You can also reach the PCIP toll-free at 1-866-717-5826 (TTY: 1-866-561-1604).