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Health Insurance Reform for Consumers

Overview

Federal law gives you and your family members some valuable - though limited - protections when you need to buy, change, or continue your health insurance. These important laws can affect the health benefits of millions of Americans and their families. Understanding these protections, as well as laws in your State, can help you make a more informed choice if you need to make a change in health coverage. It also can help you better understand the health coverage protections you have under the law.

The purpose of this on-line information is to give you an overview of how you may be affected by health insurance coverage changes found in four federal laws:

  • The Health Insurance Portability and Accountability Act of 1996 (HIPAA);
  • The Mental Health Parity Act of 1996 (MHPA);
  • The Newborns' and Mothers' Health Protection Act of 1996 (NMHPA); and
  • The Women's Health and Cancer Rights Act of 1998 (WHCRA).

This on-line information does not cover all the details of these laws. But it does give you and your family information about your rights and protections under these laws. As you read this information, it also is important to remember that health insurance coverage is a complex issue. Your coverage and protections will depend on your specific situation. For example, you may have access to different health coverage protections depending on if you work and get insurance through your workplace, or if you have individual coverage. To help you better understand this and other issues, this on-line information includes general information about the four federal laws.

For additional information, you may e-mail us at phig@cms.hhs.gov, or call us at 877-267-2323, ext. 61565.

Note:  The "Final Regulations for Health Coverage Portability for Group Health Plans and Group Health Insurance Issuers Under HIPAA Titles I & IV" document contains model language.  The Web address http://www.cms.hhs.gov/hipaa1 is referenced on pages 78727 and 78729.  This address has been updated and the current address is www.cms.hhs.gov/HealthInsReformforConsume.  When using this model language, please update the Web address. 

Downloads
DOI Contact Information - State Status Chart (PDF, 114KB) *NEW*

Interim Rules for Health Insurance Portability for Group Health Plans [04/08/1997] *NEW

Protecting Your Health Insurance Coverage [PDF, 183K]

Related Links Inside CMS

Health Insurance Reform for Employers

Related Links Outside CMSExternal Linking Policy

Final Regulations for Health Coverage Portability for Group Health Plans and Group Health Insurance Issuers Under HIPAA Titles I & IV [12/30/2004]

Nondiscrimination and Wellness Programs in Health Coverage in the Group Market [12/13/2006]

Group Market - Evidence of Creditable Coverage, 45 CFR Section 146.115(c)(3)(ii) and (iii) *NEW*

Individual Market - Evidence of Creditable Coverage, 45 CFR Section 148.124(d)(2)(ii) and (iii) *NEW*

Compliance Assistance Guide - Health Benefits Coverage Under Federal Law *NEW*

 

Page Last Modified: 04/29/2008 10:32:08 AM
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