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Health Care Reform:

Health Insurance & Affordable Care Act

How Health Care Reform Affects Your Diabetes Care

Free Preventive Care Available Now

If you have private insurance, you can get preventive care without paying a copayment or coinsurance. You can even get this care before you pay your deductible. Here's some preventive diabetes care:

  • Type 2 diabetes screening
  • Obesity screening and counseling
  • Nutrition counseling
  • Blood pressure screening
  • Gestational diabetes screening for pregnant women

Are you enrolled in a plan that existed before March 2010? If so and the plan has not substantially changed, you're with a grandfathered health plan, and it may be exempt from this part of the law. Check the plan's summary of benefits to see if you can get free preventive care services.

No Lifetime Coverage Limits

Under the Affordable Care Act, health plans can no longer limit the amount they spend toward your care over your lifetime. They also can't cancel your policy to avoid paying for your care when you have diabetes.

Children With Diabetes Must Be Covered

The new law no longer allows health plans to turn away children under the age of 19, including those with chronic conditions such as diabetes. All plans must allow families with children who have diabetes to enroll. Young adults, including those with diabetes, can stay on their parents' plan until age 26.

Benefits Starting in 2014

The health care reform law will bring more benefits to people, including those with diabetes, starting next year.

  • Adults with diabetes cannot be kept from enrolling in a health plan because of their condition. The same is true for people with other chronic conditions.
  • Health plans won't be able to charge premiums based on your health. This means plans won’t be able to increase your monthly premium simply because you have diabetes.
  • Health plans will not be able to set a yearly limit on how much they pay for the cost of your care.
  • All health plans sold to individuals and small employers must provide essential health benefits. These plans will have benefits that are as comprehensive as plans that large employers offer to workers. 
  • If you don't have insurance through your employer, you can buy insurance through your state's Marketplace, also called an Exchange. The Marketplace compares plans and premiums and answers your questions. And depending on how much money you make in a year, you may be able to get help to pay for a health plan when you enroll through your state's Marketplace.
  •  You may qualify for Medicaid even if you haven't before, depending on how much money you make in a year and where you live.

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