• Equal rates for women. Insurers have historically charged women higher rates than men for the same policies, according to the U.S. Department of Health and Human Services. They may no longer charge women more based on gender.
  • Health insurance companies may not cancel insurance for people who develop serious medical conditions. And for plan years starting Jan. 1, 2014, they may not deny coverage based on a cost limit.
  • Kids stay free. Children may stay on a parent’s insurance plan until they are age 26, even if they are married, financially independent or have an employer option of their own.

Navigating the marketplaces

Even health care reform advocates admit that negotiating the marketplaces won’t be easy. In Colorado alone, insurers are expected to offer more than 800 different plans. But a variety of resources are available to help consumers, including:

  • The marketplace website: healthcare.gov
  • A 24/7 toll-free call center: 800/318-2596
  • Local community health centers and pharmacies
  • Trained “navigators” or enrollment counselors (access them via healthcare.gov)
  • Many faith-based, community, consumer and health care organizations, including Consumer Reports and the Arthritis Foundation
  • Traditional insurance brokers

Arthritis Foundation marketplace toolkit

The Arthritis Foundation is helping connect people who have arthritis with local navigators. It also has created an online toolkit that helps consumers understand their options and find the health plan that best meets their needs.

“The toolkit was designed to be the first stop for individuals with arthritis as they explore their options for coverage in the marketplace,” says Mary Waterman, director of public health at the Arthritis Foundation. “An interactive map is included in the toolkit that allows users to select the state they live in. On the state-specific pages, they can learn how to pick a plan that makes sense for them, and they can access the checklist to help them understand the key questions that individuals with arthritis should consider when making health care coverage and benefits choices.”

The checklist is crucial, the Foundation’s Dr. White says, because it highlights benefits that are essential for people with arthritis, including coverage of prescription drugs – especially costly biologics – plus physical and occupational therapy, and orthopaedic surgeries such as joint replacements.