UnitedHealthcare, a UnitedHealth Group (NYSE: UNH) company, will continue to offer important health care insurance protections that were included in the 2010 health care reform law, no matter how the U.S. Supreme Court rules in cases currently pending before the Court.
UnitedHealthcare will continue provisions related to coverage of preventive health care services, coverage of dependents up to age 26, lifetime policy limits, rescissions and appeals.
“The protections we are voluntarily extending are good for people’s health, promote broader access to quality care and contribute to helping control rising health care costs. These provisions make sense for the people we serve, and it is important to ensure they know these provisions will continue,” said Stephen J. Hemsley, president and CEO of UnitedHealth Group. “These provisions are compatible with our mission and continue our operating practices.”
These protections are effective immediately, and will remain available to current and future customers and members. The company is not establishing any sunset provisions.
UnitedHealthcare recognizes the value of coverage for children up to age 19 with pre-existing conditions. One company acting alone cannot take that step, so UnitedHealthcare is committed to working with all other participants in the health care system to sustain that coverage.
The specific provisions being extended by UnitedHealthcare are:
Preventive Health Care Services without Co-Pays
UnitedHealthcare believes preventive health care services are an important component in helping people live healthier lives and in controlling underlying health care costs. UnitedHealthcare will continue to offer a spectrum of preventive health care services that do not require cost sharing, such as those tailored to preventive health care needs, yearly preventive medicine visits, screening for high blood pressure and diabetes, and all standard immunizations recommended by the American Committee on Immunization Practices.
Providing Dependent Coverage Up to Age 26
UnitedHealthcare was the first company to offer coverage for dependents up to age 26 and will continue to provide that coverage. This applies to dependents (adult children) up to age 26, regardless of their eligibility for other insurance coverage, including those who are not enrolled in school, not dependents on their parents’ tax returns, and those who are married.
Eliminating Lifetime Limits
UnitedHealthcare does not impose lifetime dollar limits on policies – that practice will continue.
No Rescissions, Except for Fraud
UnitedHealthcare will not pursue rescissions of individual coverage except, as provided for in the Reform law, in cases of fraud or intentional misrepresentation of a material fact. Rescissions generally are considered to be any retroactive termination or cancellation of coverage, except when due to the failure to timely pay premiums.
Providing Clear and Timely Options for Appeals
UnitedHealthcare will continue to ensure that consumers are offered a simple, accessible external appeals channel and a process that is clear and timely. The company will give consumers notice of available appeals processes and the opportunity to review their files and present evidence as part of the appeals process.
UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with more than 650,000 physicians and care professionals and 5,000 hospitals nationwide. UnitedHealthcare serves more than 38 million people and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.