CID: Health Care Reform

Health Care Reform

The federal Affordable Care Act, was signed into law on March 23, 2010. The law provides for a number of new consumer protections and while many provisions have already gone into effect, most consumer protections become effective January 1, 2014. Insurance companies can no longer refuse to insure someone because of a pre-existing condition. Other protections include no lifetime limits on certain benefits, no out-of-pocket costs for preventive and wellness services. Some consumer may also qualify for tax credits and lower premiums by shopping through Connecticutís state-based exchange Ė Access Health CT. The Insurance Department has provided many resources below to help all consumers understand their options and the lawís impact on their health insurance plans.

 ACA Consumer Alerts & Tips

As the Affordable Care Act continues to roll out, cost-sharing limits and preventive/wellness care are among membersí frequently asked questions.
If a colonoscopy is scheduled and performed as a screening procedure can my insurer impose cost-sharing for the cost of a polyp removal during the colonoscopy?

No. Based on clinical practice and comments received from the American College of Gastroenterology, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and the Society for Gastroenterology Nurses and Associates, polyp removal is an integral part of a colonoscopy. Accordingly, the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. But a plan or issuer may impose cost-sharing for a treatment not recommended as a preventive service, even if the treatment results from a recommended preventive service.

What is included in a "well-woman" visit?

The Health Resources Services and Administration Guidelines recommend at least one annual well-woman preventive care visit for adult women to obtain the recommended preventive services that are age- and developmentally appropriate, including preconception and prenatal care with no cost-sharing. These visits will help women and their providers determine what preventive services are appropriate to help women get the care they need to be healthy.

For further help with these or other health insurance topics, please contact out dedicated Consumer Affairs team at 800-203-3447

Previous Consumer Alerts & Tips

How the ACA reforms the way insurance is priced:
Insurance Department Legislative Presentation on Rate Reforms

Department updates Legislatureís Insurance & Real Estate Committee on 2014 rating reforms
{Ask Question}
JANUARY 31, 2017.
The following FAQs address current coverage options, penalties and exemptions:

Need Further Assistance?
Contact the Department's Consumer Affairs Unit

By Phone: 800-203-3447 or 860-297-3900
By E-mail:
{Access Health CT}
1-855-805-HEALTH (1-855-805-4325)

Essential Health Benefits (EHB):
What is covered under the ACA?

Beginning January 1, 2014,insurance plans must have the following EHBs:
  • Ambulatory Patient Services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health, substance abuse disorder services
  • Prescription drugs
  • Rehabilitative and daily assistance services and devices
  • Laboratory services
  • Preventive, wellness services, chronic disease management
  • Pediatric services, including oral and vision care
ACA Implementation Timeline - An interactive calendar

Content Last Modified on 1/3/2017 2:00:31 PM