The Affordable Care Act is LGBTQ-Friendly!
The Affordable Care Act (ACA) gives access to more affordable health coverage and care. It also benefits LGBTQ communities by addressing insurance issues that previously prevented many from accessing the coverage and care they need.
Here are some of the ways the ACA has changed the health insurance system that can benefit you and your family:
Health plans cannot discriminate based on sexual orientation or gender identity, meaning individuals cannot be denied coverage or charged higher premiums just because they are gay, lesbian, bisexual, or transgender, or because they have a condition such as HIV.
Legally married same-sex couples can obtain financial assistance through the Marketplace, regardless of which state they live in, and plans offering spousal coverage must make that coverage available to same-sex spouses.
Plans cannot deny coverage because of pre-existing conditions, including behavioral health conditions, HIV, or a transgender medical history, and enrollees cannot be dropped from coverage except in cases of intentional fraud or nonpayment of premiums.
You have a right to equal coverage
Section 1557 of the Patient Protection and Affordable Care Act prohibits discrimination on the grounds of race, color, national origin, sex, age, or disability in health programs and activities. Importantly, the sex nondiscrimination protections of Section 1557 include gender identity and sex stereotyping, and provide a unique opportunity to ensure equal access to health care for all LGBTQ Americans.
You have a right to quality coverage
If patients experience difficulty getting coverage for behavioral health services, or for other medically necessary services they believe are covered under their plan, they may seek redress through an appeal with the insurance company and may also file a complaint with their state’s insurance commissioner or with the Office for Civil Rights at the U.S. Department of Health and Human Services.
Claims and appeals are something we can help you with as your agent!
Private plans must cover prescription medications, although particular medication coverage and cost will vary by plan. If a consumer needs a certain medication that is not covered, private plans must have a process for a consumer to request a noncovered prescription drug.
Most plans must cover some preventive services, including adult depression screenings and child behavioral assessments, at no out-of-pocket cost.
Under the Mental Health Parity and Addiction Equity Act (MHPAEA), insurance companies cannot apply more restrictive cost-sharing or other benefit limitations to mental health services than they do to medical/surgical services.
You have a right to privacy
The Health Insurance Portability and Accountability Act (HIPAA) provides for the protection of health information, including information in a person’s medical record such as information related to a person’s sexual orientation and transgender status. Protections are provided against improper disclosure of personal medical information or other sensitive information to employers, family members, or others without proper consent from the individual patient.
Patients should be aware that providers must share some information with insurance companies about their patients and the care provided to be reimbursed for their services. That information does not typically include sexual orientation or gender identity.
You qualify for insurance
Whatever your situation, YOU QUALIFY for health insurance. Text or call us at 801-609-8699 with any questions or to get a free quote. You can also schedule an appointment to speak with an agent.
About Utah Avenue Insurance
Utah Avenue Insurance is your local health insurance experts. Our agents are here to help you with all your health insurance questions. Utah Avenue can help you with marketplace (aka Obamacare) plans, private health insurance and Medicare. If you have questions about how your medical insurance plans work or need help enrolling in a plan, we can help you. As always, our service is free to you.
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