You may be thinking of renewing your health insurance policy, but don't know whether your current policy is competitive. Knowing what the bare minimum for coverage is will help you determine whether your policy is bare bones or generous. The Affordable Care Act defines essential benefits that every health insurance policy must cover. These are as follows:
This is where you walk into a healthcare facility within your plan's network, get treatment, and go home the same day. Find a family doctor you'd like to work with, and ensure that you choose an insurance company that is able to work with them.
This covers hospitalization. Please note that you may be required to pay 20% of the bill out of pocket. Beware, though, since hospitalization bills can be quite high.
Preventive health tests are free of charge but expect to be charged for diagnostic tests.
This covers dental and eye care for children. Dental care includes teeth cleaning at least twice a year, X-rays, and fillings.
Your prescription drugs are likely to cost you more than what your insurance will pay for.
This benefit allows you to prevent illnesses before they occur. It also covers the management of chronic illnesses. Preventive healthcare may include screening for chronic illnesses like cancer, diabetes, HIV, depression, and high blood pressure, among other conditions. Under normal circumstances, such care should be free of charge.
Pregnancy & Childbirth
Prenatal care as well as care for the newborn child is free of charge.
Mental health is now put on the same plane as other physical ailments, ensuring that people with such conditions do not suffer from discrimination. Problems related to substance use, counseling, and psychotherapy are also included.
Emergency care is considered just that; an emergency. In case of sudden illness requiring urgent attention, such as a stroke or heart attack, you will not be penalized for seeing an out-of-network doctor or facility.
Rehabilitation and Habilitative Services and Devices
In case of injury or accidents, rehabilitative services are meant to help you recover from physical or mental conditions. Habilitative care, on the other hand, helps the individual to gain and maintain skills they didn't have before, such as speaking or walking. This is welcome news to people with disabilities and/or their guardians. The plan may cover devices such as canes, wheelchairs, walkers, etc.
Check any health insurance plan against these legal requirements. Also ensure you fully understand what your policy covers. In case of doubt, ask for clarification.Share