Health Care Coverage for the Senior Care Industry

The Affordable Care Act helps to protect the rights of the consumer in addition to making it access health care easier. Insurance providers will be required to follow a number of new regulations which will enhance the quality of the health care coverage they provide to individuals and businesses including the senior care industry. For example, carriers will be required to provide an easy to understand summary of their health care benefit plans to consumers. This makes provides consumers with a greater understanding of what a plan will cover, making it easier for them to choose the most appropriate plan for their needs. Some states may also implement consumer assistance programs. These help to advise consumers on choosing a plan and support consumers in managing any subsequent problems that they may experience, such as having insurers deny coverage for certain treatments. These programs will also advise consumers of their rights and provide a forum for consumers to file any complaints. Ultimately, under the patient’s bill of rights, consumers will have a greater control over their own healthcare.

Health care coverage will also be required to cover preventative care at no additional cost to the consumer. This may include therapies, diagnostic tests, such as cholesterol and blood pressure, and routine vaccinations, amongst many others. The cost to purchase health care insurance will also be reduced in several ways. The implementation of public benefit exchanges will provide a competitive marketplace in which companies and individuals can choose from a variety of plans, in ways which are cost effective. The Affordable Care Act also requires that insurance companies spend a certain percentage of health care premiums only towards healthcare they provide. This is currently set at 80% of premiums received. Moreover, insurance companies can no longer charge high premiums to women or individual’s based on their age.

Companies must be aware of the changes to health care coverage, particularly the new options available to them which may help them to afford to provide coverage. Companies should also be aware of their eligibility to participate in public benefit exchanges and tax credits. However, companies must also decide how these new options will impact the ways in which they administrate their benefits, including enabling employees to have a greater control over their plans. Certain carriers offer software solutions to help companies to administrate their benefits, a form of outsourcing certain aspects of the administration. Companies continue to have control over how they manage these applications in house, but this does reduce some of the administration tasks, freeing up HR departments to concentrate on other areas of the management of the workforce. In choosing this option, companies must ensure that their processes, software, and applications are compatible with those with those of the carrier. This can greatly help to ensure that new benefits are implemented well within the company.



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