updated 9/15/2010 8:32:25 AM ET 2010-09-15T12:32:25

The new health care law adds consumer protections that kick in Thursday, forcing insurers to cover kids with pre-existing conditions, eliminate lifetime caps and stop cancelling policies when people become sick.

But most consumers won’t see any changes until after Jan. 1 when their new health plan year begins.

In the meantime, employees will be getting ready for fall’s “open enrollment” period, when they pick their health coverage for the following year. In addition, people who buy their own health insurance will be researching their options. And Medicare beneficiaries will be able to change their coverage later this year, if they want to. Here’s a look at how the law affects people who get their coverage at work, buy their own health insurance or are enrolled in Medicare.

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Q: I get my coverage through work and the “open enrollment” period for next year is approaching. I’d like to keep my current health plan. Will it be affected by the new law?

A: Your plan will feature some new consumer protections. For example, your plan won’t be able to set a lifetime limit on coverage. And if you have an adult child up to age 26 who can’t get health insurance at a job, you’ll be able to keep him or her on your health plan.

These changes kick in for plan years beginning on or after Sept. 23.

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If your employer makes significant changes — like cutting benefits or raising your out-of-pocket costs beyond a specific amount — the plan is considered a new plan (rather than an existing “grandfathered” one) and must include a wider set of consumer protections.

Q: Like what?

Patients will get, for example, certain preventive services such as breast cancer screenings and cholesterol tests without paying deductibles or co-payments. In addition, they’ll be able to see obstetricians and pediatricians without getting prior authorizations. Recommended immunizations also must be provided at no cost.

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Q; What if my employer offers a new plan and I want to switch to that?

A: In that case, your coverage would include the wider set of protections.

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Q: Will my health insurance cost less?

A: Probably not. Health insurance premiums have been increasing steadily over the last decade and that trend is continuing. According to a new report from the Kaiser Family Foundation and the Health Research & Educational Trust, workers nationwide on average are paying 14 percent, or $482, more for family health insurance coverage in 2010 than in 2009. Employers, struggling with the recession, aren’t increasing their share. Instead, they’re shifting more costs onto employees, according to the survey. (KHN is a program of the foundation).

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A recent study by the National Business Group on Health found almost two-thirds of employers planned to ask employees to contribute more toward their premiums.

Q: I’m a small business owner. Do I have to offer coverage to my workers this fall? And if I do, will the government help me pay for it?

A: No business owner — small or large — is required to offer coverage. But small businesses with 25 or fewer full-time employees who earn an average yearly salary of $50,000 or less will qualify for a tax credit up to 35 percent of the cost of premiums. The credit increases to 50 percent in 2014 for most small employers. To qualify for the credits, businesses must cover at least 50 percent of the cost of workers’ insurance.

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Starting in 2014, businesses with 50 or more employees that don’t provide health care coverage and have at least one full-time worker who receives subsidized coverage in the health insurance exchanges will have to pay a fee of up to $2,000 per full-time employee. (The firm’s first 30 workers would be excluded from the fee.) Businesses with 50 or fewer workers would be exempt from the requirement.

Q: I buy my own health insurance. How will the health law affect my coverage?

A: For policy years starting after Sept. 23, all health insurance policies in the individual market will be barred from cancelling coverage once you get sick — a practice known as “rescission” — unless you committed fraud when applying for coverage. Insurers will be prohibited from setting lifetime limits on your coverage. The plans must allow you to keep an adult child up to age 26 on your health plan.

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New policies can’t deny coverage for children up to age 19 based on a pre-existing medical condition. But “grandfathered” plans can; they can also set annual dollar limits and require cost-sharing for some preventive services. Most people in the individual market are expected to move to a new plan by 2014. Analysts say that most plans in the group market also will have likely lost their “grandfathered” status due to changes made to the plans.

Other provisions of the law will kick in later. For example, as of 2014 insurers won’t be able to refuse to cover adults with pre-existing medical conditions. That same year, individuals whose incomes are up to 400 percent of poverty — $88,200 for a family of four at the current poverty level — will qualify for subsidies to help purchase health insurance on exchanges, marketplaces where consumers can shop for coverage. At that point, most people will have to have health insurance or pay a fine.

Q: I’m on Medicare. Will my benefits change?

A: Your basic package of Medicare benefits won’t shrink and in fact will expand under the law. But if you’re in a Medicare Advantage plan — a private plan that offers Medicare benefits — you might lose some extra benefits at some point.

In terms of the overall Medicare program, let’s start with prescription drugs. As of late August, one million Medicare beneficiaries received a $250 check to help cover prescription drug costs in what’s known as the doughnut hole. That’s the gap in coverage where beneficiaries must pay the full cost of their prescriptions until catastrophic coverage kicks in. Starting next year, beneficiaries will receive a 50 percent discount on brand name drugs and a 7 percent discount on generic drugs while they are in the coverage gap. The health law closes the gap entirely by 2020.

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In addition, beginning next year, Medicare beneficiaries won’t have to pay co-payments or deductibles on many preventive health care services, including diabetes and cervical cancer screenings. Medicare will also pay for an annual wellness visit to the doctor.

To help pay for the health overhaul, Congress is cutting payments to Medicare Advantage plans, beginning the year after next. Beneficiaries won’t lose any of their basic Medicare benefits as a result of the reductions but some Medicare Advantage insurers could decide to stop offering additional benefits, such as coverage for eyeglasses or gym memberships.

Q: Many Republicans have criticized the health care law as too intrusive and too expensive. If they pick up seats in the November election, how will the law be affected?

A: Some Republicans have threatened to block funding for the implementation of the law; others have called for its outright repeal. But accomplishing either would be tough unless they win large majorities in both the House and Senate.

President Barack Obama would likely veto any legislation to gut the law, so Republicans would need a veto-proof majority — two-thirds of both chambers — to override such an action. Also, some Republicans might be reluctant to repeal provisions of the bill that are popular with the public, such as keeping a child up to age 26 on their parents’ health care plan or outlawing rescissions and lifetime and annual limits.

© 2012 This information was reprinted with permission from KHN. Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

Vote: Now that health care changes are beginning, are you in favor of the new law?

Video: What to know about new health care rules

  1. Transcript of: What to know about new health care rules

    MATT LAUER, co-host: We're back now at 7:43. This morning on TODAY'S HEALTH , some new health care rules. Several provisions of the health care reform law kick in today. What does that mean for you? CNBC's Bertha Coombs is here to explain. Bertha , good morning to you.

    BERTHA COOMBS reporting: Good morning, Matt.

    LAUER: We've been talking about this for years now.

    COOMBS: Hm, yeah.

    LAUER: Today's the day we actually see some of these changes taking place. Give me the headlines. What are people going to see?

    COOMBS: All right. Essentially, you know, the whole plan starts 2014 , when people can buy into the insurance exchange. But a lot of the protections and expanded coverage start today on the six month anniversary of the passage of the bill. So one of the big ones is no more lifetime limit on insurance benefits. This is important to people who have conditions like hemophilia or cancer...

    LAUER: Chronic illnesses.

    COOMBS: ...who can max out.

    LAUER: Right.

    COOMBS: So now you can't max out on lifetime. And also, the yearly limits are much more generous now, they're up to 750,000. Also, the big one, the number one that a lot of people have looked at is that now you can keep your adult child up to their 26th birthday on your plan. Thirty percent of young adults between 18 and 24 are uninsured because a lot of them don't have jobs that pay them insurance.

    LAUER: Yeah. Let's stop right here because I know this isn't something that you think just universally people should say, 'Great, let the employer put that child on the plan.' You think there's a way that you should actually compare costs because you may be able to go out and get a high deductible policy outside of your employer's plan and save money.

    COOMBS: Exactly. Depending on where you live. I talked to a number of analysts who say really you should crunch the numbers on here because employers make you pay more out of pocket, pay more of the costs for that dependent care. So particularly if you're adding back a young adult , depending on where you live, you might be able to get a high deductible plan that's cheaper in a state like California , for example.

    LAUER: Preventative care also now becomes covered under policies.

    COOMBS: Mm-hmm.

    LAUER: If you buy your own insurance, the same three big...

    COOMBS: Exactly.

    LAUER: ...provisions apply. Any other changes?

    COOMBS: Yeah, there's also some extra protections. On the preventive care , that includes not just, you know, annual exams, mammograms, colonoscopies, but also well baby visits...

    LAUER: Right.

    COOMBS: ...child visits and immunizations, as well. So that's a lot that you no longer have to put out of pocket. They're free now, no co-pays. If you buy your own insurance, there are also some new protections in terms of children. Children with pre-existing conditions can't be denied insurance. But if you look for a policy only for your child, you may have a more difficult time finding one of those. A lot of insurers worry that they're only going to have to cover sick children, so they're not going to offer that. They will give it to you if you do a family plan.

    Children 19 and under: no denial for pre-existing conditions Policy can't be canceled because of illness

    LAUER: Real, real quickly at the end here, I want to just give some tips of yours for people -- ways to save money under this new program. First of all, stay in your network, that always helps you save money. Drugs, use generics.

    COOMBS: Use generics. Use mail orders, and also try to get larger prescriptions. You know, rather than a 30-day prescription, if you can get a 90-day prescription that's usually more cost effective.

    LAUER: And when possible, take advantage of those wellness incentives.

    COOMBS: Exactly. And those tax-free savings plans, flexible savings plans. If you're on your employer's. Or if you have a high deductible plan, those are the plans that say, look, you pay more out of pocket for the benefit of lower premiums, but you can save with health savings accounts . And the health savings account have the benefit that those roll over. That can boost your health dollars by about 30 percent because you're not paying tax on those.

    LAUER: A lot of -- a lot to consider. Bertha Coombs , thanks for putting it into perspective for us. I appreciate it. It's 7:46. Up next, the beauty bandit learns her fate for allegedly stealing cosmetic treatments. But first, these messages.