Does Health Insurance Cover Diabetes?
While the majority of states have some type of law in place that does not let health insurance companies discriminate against people with diabetes, some policies may still exclude the coverage. The reforms put in place with the Affordable Care Act (ACA) will address these exclusions, although it will take some time before the full extent of the Act is felt.
As of 2009, state legislation in 46 states requires insurance companies to offer coverage to those with diabetes, according to the National Conference of State Legislatures, but those laws can vary widely. Certain states, for instance, may offer coverage for diabetes in new policies but may not have to include diabetes coverage in existing policies already in place.
How will the Affordable Care Act Help People with Diabetes?
Once all phases of the ACA go into effect in 2014, the American Diabetes Association (ADA) pointed out several major benefits that apply to people with diabetes. Health insurance companies will no longer be able deny someone coverage based on any pre-existing condition, no matter how old that person is.
The ADA also reports insurance premiums will not increase due to gender or health status and Medicaid coverage will be expanded to reach more people in the low income brackets who need it most. Small group health plans and individual health insurance plans will be mandated to offer an essential health package that meets the government’s minimum requirements.
How is the Affordable Care Act Helping People with Diabetes Now?
Certain changes that apply to everyone can especially benefit those with diabetes. Changes include new coverage options for people with diabetes or other conditions.
The options come from a plan specifically created to address the needs of people with pre-existing conditions that may have been denied coverage in the past. Known as Pre-existing Condition Insurance Plans, or PCIPs, these policies are filling the gap until the ACA provisions banning pre-existing condition discrimination go into full effect in 2014.
Children with diabetes don’t have to wait until 2014, as insurers were banned from denying them coverage because of their diabetes as of September 2010. Additional ACA safeguards for people with diabetes include doing away with lifetime limits on benefit coverage, the ADA reports. The ACA also prohibits insurance companies from stopping their coverage when a policyholder is diagnosed with diabetes or suffers from complications related to diabetes.
The age limit has changed for children with diabetes to remain covered by their parents’ policies, which they can now do until age 26. The ACA also limits the costs seniors must pay out of their own pockets.
Prevention is big in the Affordable Care Act, and the reform is putting grant money and funds where the problem is, according to the ADA. The first example of this comes from the National Diabetes Prevention Program, which kicked off in 2012 and offers grants to community organizations that enact programs to help decrease the instances of Type 2 diabetes in the community.
A second example comes from funding dedicated to public health programs aimed at promoting overall wellness and preventing disease. The ADA reports receiving $10 million from the funds to help with its programs.
Preventative care is so big across the board that the ACA mandates many free services linked to preventative care. The care is to be provided at no cost to the insured and no shared costs by other policyholders. The wide scope of free preventative services includes such options as testing, screenings, and counseling. Two preventative care additions that specifically relate to diabetes are the inclusion of screening pregnant women for both Gestational and Type 2 diabetes.
What Preventative Care Can Help Manage Diabetes?
In addition to screenings and tests to check for the development of diabetes or factors that often lead to diabetes, a major part of preventative care is lifestyle changes. The Mayo Clinic offers five tips to help prevent diabetes, all of which rely on changes you can make in your own way of life.
Getting exercise tops the list of tips, with the greatest benefits coming from a combination of aerobic activities and resistance training. Exercise can help prevent diabetes by helping you to maintain a healthy weight, lowering your blood sugar levels, and increasing your sensitivity to insulin. This assists with keeping your blood sugar levels stable.
Losing weight and maintaining a healthy weight are also on the list. Excess weight is a major factor in diabetes, and keeping your weight in check can help keep your health in check. Every pound you lose has the power to improve your health.
What you eat can also play a part in your risk of developing diabetes. Three of the preventative tips offered by the Mayo Clinic are linked to food. One says to get plenty of fiber, which stabilizes blood sugar and lowers your risk of heart disease. Another is to eat whole grains, which also help to maintain blood sugar levels. The third is to steer clear of fad diets in favor of an overall healthy eating plan.