Reform

What does health care reform mean to me?

Health reform will bring a number of improvements and additional benefits for consumers – but at a cost.

These changes look different for every consumer. Rates will be higher, but some customers will pay less than they do now. Some will pay more.

Find out more about health care reform and how you can get the most benefit from the law.

Buying Insurance

The Affordable Care Act makes large, sweeping changes to the way health insurance is packaged, priced, and delivered.

Insurers may no longer rate people based on their health status and must meet certain pricing restrictions.

Exchanges will alter the way people without employer-sponsored coverage shop and compare health insurance plans. Some of the changes will benefit some individuals and families, while others may experience an increase in insurance premiums.

Using Insurance

The Affordable Care Act includes a requirement that all non-grandfathered individual and small business insurance plans must cover a certain set of services within 10 categories established by the Institute of Medicine.

Though the 10 categories are dictated federally, the specific services that must be provided are determined at the state level by the selection of a benchmark plan.

They include:

• Ambulatory patient services
• Emergency services
• Maternity and newborn care
• Mental health and substance use disorder services, including behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devicesLaboratory services
• Preventive and wellness services
• Chronic disease management
• Pediatric services, including oral and vision care In North Carolina.

The benchmark plan is a BCBSNC plan and covers a comprehensive set of services that all North Carolina health plans must now offer in the individual and small group markets.