What Will My Health Insurance Cover?
Beginning in 2014, the Affordable Care Act required that health insurance plans, inside and outside of the government’s Health Insurance Marketplace, cover a number of different health-related categories known as essential health benefits. These plans must cover ten areas of service
Essential health benefits include:
1. Ambulatory patient services (outpatient care you get without being admitted to a hospital)
2. Emergency services
3. Hospitalization
4. Pre and post natal care
5. Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)
6. Prescription drugs
7. Rehabilitative and habilitative services and devices (services and devices that help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services (including dental and vision)
Will My Health Insurance Cover Anything That is Not an Essential Benefit?
It’s possible. Essential health benefits are simply the minimum coverage requirements for health insurance companies. Varying plans may cover a number of additional benefits, such as birth control, breastfeeding and dental coverage, which are not required under the essential health benefits.
While these essential health benefits are required for most health insurance plans, each state may have additional coverage requirements.
Note: “grandfathered plans” are not required to cover the essential health benefits, though many do.
Health Insurance Providers Raleigh, NC
The Wooten Agency is available to help you find the plan that is right for you. Whether you are under the age of 65 and in need of health insurance, or are a Medicare recipient in need of additional coverage, the Wooten Agency is happy to help.
Contact the Wooten Agency in Cary, NC today to learn more about essential health benefits, or to receive a complimentary health insurance consultation!
