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At what cost? Specifically, at what price point are the insurance co's limited to charge for PECs? Mandating w/o cost-controls is an invitation to charge as muc
by tunap 8y ago
At what cost? Specifically, at what price point are the insurance co's limited to charge for PECs? Mandating w/o cost-controls is an invitation to charge as much as necessary to rid themselves of the liability, no? So my question is, where does it mandate what PEC costs are allowable to avoid abuse by providers?
- dragonwriter 8y ago> So my question is, where does it mandate what PEC costs are allowable to avoid abuse by providers? The ACA prohibits denying coverage or charging additional premiums based on, or limiting in any way coverage for services because they are related to, pre-existing conditions. (Now, within the existing state and federal rules on minimal coverage, insurers may limit coverage for particular conditions, but can't differentiate based on whether they were present before the person sought coverage.) The real big deal, though, is the linked prohibition on rescission: before the ACA, insurance companies would frequently do focused investigations to find evidence of non-disclosure pre-existing conditions, however minor and unrelated to the current condition, when an insured person incurred high covered expenses, then use any discovered pre-existing condition as an excuse to retroactively cancel their insurance avoiding the high pending bills and dumping them on the patient.