What is the Patient’s Bill of Rights?
The Patient’s Bill of Rights under the Affordable Care Act guarantees the following:
- The right to appeal: If you are denied coverage for a particular treatment or service, you have the right to ask that your plan reconsider.
- Ban on discrimination against patients with pre-existing conditions: Under the Affordable care Act (ACA), no one seeking coverage can be discriminated against because of a pre-existing condition.
- Your choice in provider: You can choose the primary care provider you want from your plan’s network.
- Young adults are allowed to extend their coverage: If you are under the age of 26, you may be eligible for coverage under your parents’ insurance plan.
- No arbitrary withdrawals of coverage: If you or your employer make an honest mistake in filling out your insurance application, your coverage will not be cancelled.
- Ends lifetime limits on coverage: Lifetime limits on most benefits are banned under the ACA. This means health plans can no longer set a dollar limit on what they would spend for your covered benefits during the entire time you were enrolled in that plan.
- Review of premium increases: Health plans’ premiums are subject to both state and federal review where regulators ensure coverage meets all benefit requirements.
- Premium dollars go to medical care: The ACA includes a limit on how much health plans can spend on administrative and overhead costs. That means that the majority of your premium dollars must go to medical care.
- Preventive care services are covered at no cost: You may be eligible for recommended preventive health services with no copayment.
- Barriers to emergency services are removed: If you receive emergency care at a hospital outside of your health plan’s network, the amount you pay in cost sharing won’t be any higher than what you would pay for in-network services.
Didn't find what you needed? Give us feedback.