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No More Lifetime Limits: Real Life Effects of the Health Care Law

No More Lifetime Limits: Real Life Effects of the Health Care Law

written by Kathy Mitchell

A million dollars is still a lot of money, until we get seriously ill.

Three year old Gwendolyn, of Santa Barbara, California, was born with spinal muscular atrophy. Covered under her father’s health insurance plan, she has been getting excellent care but the astronomical bills were quickly approaching his lifetime coverage limit. After that, her father didn’t know how he would keep the treatments going or avoid bankruptcy.

Until now.

The new federal health insurance law, one year into its incremental implementation, eliminated lifetime limits for most health plans and has started to phase out annual coverage limits as well.

But you have to watch the fine print. While lifetime limits have been largely eliminated, the new right to a health plan that doesn’t cut off your treatment at an arbitrary dollar amount each year (the annual limit) doesn’t apply to what are called “grandfathered” plans.

Grandfathered plans are those that existed when the health-care reform law was signed on March 23, 2010, and that have not made significant reductions in benefits which would cause them to lose that status. There are still a lot of grandfathered plans on the market. You may be in one.

Americans made it clear during the extensive national debate about the new health law that they wanted the ability to keep the plan they have if they like it. In order to preserve our existing system of employer and private plans, while phasing in new consumer protections to help those most in need, the law exempted plans from certain reforms unless they were amended to reduce coverage.

There are lots of new benefits and new rights, and a few things like this you need to know to get the most out of the new health law.

Consumers Union, the nonprofit publisher of Consumer Reports, has produced a new guide to the health law on the occasion of its one year anniversary. Read the Guide online, or download the pdf. If you like it, order a few to give to friends and family so they can get beyond the hype and find out exactly what the new law can (and can’t) do for them.

And finally, read Nancy Metcalf of Consumer Reports’ “Haves and Have-Nots” of the bill, broken down by demographic.

Take Action: Know the facts about the new health care law.


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photo courtesy of Bill and Victoria Strong

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7:53AM PDT on Apr 18, 2011

insurance companies need to be made non-profits and then their focus will turn to providing health coverage for people not their bottom line as long as they are for profit that is all they will care about

12:36PM PDT on Apr 1, 2011

Thanks for the informative article.

11:46AM PDT on Apr 1, 2011

To i tak jest du¿o lepiej ni¿ w naszej s³u¿bie zdrowia, o niej szkoda gadaæ

11:42AM PDT on Apr 1, 2011

I still don't understand the health care bill.

10:58AM PDT on Apr 1, 2011


10:55AM PDT on Apr 1, 2011

Thank you for this valuable information.

10:50AM PDT on Apr 1, 2011

Insurance policies of all kinds should be shorter and written in plain English so that the average consumer doesn't need a law degree. The same goes for documents involved in obtaining or re-financing a mortgage.

10:48AM PDT on Apr 1, 2011

Until the playing field is level for us all, it cannot work for all of us...but I won't hold my breath

10:35AM PDT on Apr 1, 2011

Thank you for the info I agree with Arid Warud. Dont trust them

10:25AM PDT on Apr 1, 2011

Thank you for the info. Sounds like this will be an interesing read.

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
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