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Health Care Reform:

Health Insurance & Affordable Care Act

How Health Reform Affects Arthritis Care Costs

Health care reform offers help for people with chronic conditions like rheumatoid arthritis or osteoarthritis. Under the Affordable Care Act, you are guaranteed care for these conditions. You'll also have access to medicine and pain treatment, if you need it.

If you have a child with a chronic condition, such as juvenile arthritis, you are guaranteed insurance coverage for your child. Your child can stay on your insurance plan for much longer than in the past.

The exception is a “grandfathered” plan -- a health plan that existed before March 2010 that has not made any significant changes to its benefits. Grandfathered plans do not have to offer this coverage. If you are not sure whether your health plan is grandfathered, call your insurance company.

Arthritis Coverage

Under the Affordable Care Act, you can get or keep insurance coverage after you or your child is diagnosed with arthritis. This is because:

  • You cannot be turned down for health insurance because of your arthritis.
  • You can buy an insurance policy just for your child, even if he or she has arthritis.
  • Your insurance cannot be canceled because you develop arthritis.
  • Your children must be covered by your insurance if you choose to include them on your policy. This is true even if a child already has arthritis.
  • Since the start of 2014, you must be allowed to buy a health plan from any insurer even if you have arthritis.
  • All of your children can stay on your health plan until they reach age 26.

You may also benefit from rules that limit how much you will pay for your care or medicines. For instance:

  • You will not have a dollar limit on how much can be spent on your care. Annual and lifetime limits have gone away.
  • If you are sick, you can't be charged more for health insurance.
  • Your out-of-pocket costs will be limited. Health plans must place a cap or a maximum on how much you spend on your care. Once you reach that amount, your insurance company covers the rest of your costs. That includes what you would spend on copays and deductibles for medical care and prescriptions.

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