How does health care reform affect doctors?

The Patient Protection and Affordable Care Act became law on March 23, 2010. 

We continue to examine the law to figure out how doing business with us may be different for you. We'll post information on this website as it becomes available, so check back often. We'll also provide information in The Record and BCN Provider News.

Here's what we know now.

Insurers are required to cover preventive services and immunizations with no member cost-sharing

This will be effective for most groups and individuals on Jan. 1, 2011. Please ask to see the member's ID card and check eligibility and benefits on web-DENIS to see when this becomes effective.

Note: Preventive codes are available on web-DENIS. Log in to Provider Secured Services to view them.

These resources explain more about how we're complying with the requirement:

• Health care reform article
  
• Medicare Supplemental Requirements (PDF)

The Medicare Part D coverage gap ("donut hole") will be phased out.

Medicare Advantage is changing. Find out more about the changes in our Medicare Advantage Reform Alert.

Insurers will:

• Remove lifetime dollar limits for essential services
• Remove pre-existing condition exclusions for children up to age 19
• Clarify emergency services

Find out more about these and other changes in the Patient's Bill of Rights Reform Alert.

Insurers also have to:

• Extend coverage for dependents up to age 26
  
• Require prescriptions for over-the-counter drugs and other items that members want reimbursed by their health spending accounts
• Revise the appeals process for members