Frequently Asked Questions

Health First Health Plans wants to keep you up-to-date with news regarding The Patient Protection and Affordable Care Act (PPACA). The Department of Health and Human Services is releasing clarified information on the new law daily, as our internal Healthcare Reform team is working diligently to interpret this guidance. We will update this information as more details are released and the information becomes available.

What is the goal of the new health care law?

The Patient Protection and Affordable Care Act (PPACA) is intended to make health insurance coverage available to more people in America. Health First Health Plans has been part of the solution all along and was founded on the principle of ensuring quality health care and coverage are available to residents of Brevard County and the City of Sebastian at an affordable cost.

Is it true people with Medicare will receive a $250 rebate in 2010?

If you have Medicare Part D, reach the coverage gap, and don't already get Extra Help for your prescriptions, the government will give you a one-time $250 rebate. You do not need to apply for it or submit paperwork—the government will automatically send you a check! The checks will begin mailing in June.

• Note: This applies to members of Health First Medicare Plans who have the Classic, Value, and some Employer Group plans.

Does the new law focus on preventive services?

Yes, the PPACA requires all plans to cover preventive services with no cost share. This may include childhood immunizations and screenings recommended by the Centers for Disease Control and Prevention (CDC) as well as preventive services for men and women. The government is still determining exactly which services will be included in this provision, but since our plans have always covered preventive services with no cost share, we don’t expect this to be a big change for our members. If we have to change any of our benefits to meet this requirement, they will be included in plans that begin or renew on or after October 1, 2010.

How long can young adults be covered on their parents’ plans?

Plans that include dependent coverage and begin or renew on or after October 1, 2010 will allow young adults up to the age of 26 to be covered on their parent's plan, regardless of the young adult's financial dependence, marital status, or school enrollment. Since the state of Florida already allows young adults up to age 30 to be on their parent's plan, the law will have minimal impact to Florida residents.

• Note for self-funded plans: This will affect self-funded plans that are not required to follow the state statute allowing coverage for young adults up to age 30. When self-funded plans begin or renew on or after October 1, 2010, they’ll be required to offer coverage to dependents up to the age of 26 (for example, if a self-funded group normally renews coverage on January 1, they must follow this new federal rule beginning January 1, 2011).
• Note for Medicare plans: Dependents cannot be covered on Medicare plans.

Are plans required to eliminate maximum lifetime limits?

All health insurance plans that begin or renew on or after October 1, 2010 will be prohibited in setting maximum lifetime limits on benefits.

Is it true plans must cover pre-existing conditions?

Plans that begin or renew on or after October 1, 2010 must cover pre-existing conditions for children under the age of 19. Plans that begin or renew on or after January 1, 2014 must also cover pre-existing conditions for adults aged 19 and older.

Last updated: 5/26/2010