Frequently Asked Questions

Q: What consumer protections will I get this year if I buy coverage in the individual market?

You will have access to new insurance choices in the same insurance marketplace where all members of Congress will buy their insurance. Either way, there will be new protections from insurance company abuses, and tax credits will make coverage more affordable.

Q: What consumer protections will I get this year if I buy coverage in the individual market?

A: Beginning in September 2010,  insurers will be prohibited from placing lifetime limits on what they will pay for your medical care, and they can only apply restricted annual benefit limits. Insurers will no longer be able to arbitrarily cancel your insurance policy when you get sick, except in cases of fraud.

Insurance companies will be prohibited from denying coverage to children with pre-existing conditions. This applies to all new plans in the individual market. 

Beginning in September 2010, all new individual market health plans must provide coverage for preventive services.  Recommended prevention and vaccination services will be covered without any deductibles or copayments. They must also have a straightforward and independent appeals process so you can appeal decisions by your health insurance plan.
Beginning on January 1, 2011, insurance companies will be required to spend most of your premium dollars on your care, not on profits and overhead -- 75 percent in the individual market -- and rebate any excessive overhead to enrollees.

Similarly, starting in plan year 2011, companies that sell insurance in the individual market that jack up rates will have to disclose requested premium increases publicly.  If that rate increase is found to be unreasonable, the insurer may be prohibited competing for your business in the new state-based exchange that will begin operating in 2014.