Services Covered Under Obamacare and the ACA (Affordable Care Act)
The Affordable Care Act provides several benefits to those who have health insurance. These benefits include the following:
- The amount of health insurance used can’t be limited
- Certain Health Insurance coverage cannot be restricted
- An insurance company can’t deny someone who is chronically ill
- Wellness and pregnancy exams are free and without a co-payment
- Health insurance companies can’t raise premium rates without state approval
- Children up to the age of 26 can be added to their parent’s health insurance plan
- A person can’t be denied health insurance because of their pre-existing conditions
- Health insurance companies can’t drop someone from the plan because they become ill
All Health Plans Must Be ACA Qualified
A Qualified Health Plan, or QHP, is a health insurance plan that provides coverage for the 10 essential benefits outlined in the 2010 Affordable Care Act. What are “Essential Health Benefits” and who must have them? From 1/1/2014 and forward, all new health insurance plans (insured small group and individual health insurance plans) must cover the 10 bulleted benefits below called “Essential Heath Care Benefits” to qualify as being an ACA plan (Obamacare). Qualified Health Plans MUST cover these 10 items without any lifetime or annual limits on these “Essential Health Benefits.”
Essential Benefits Included in the Affordable Health Care Act
- Prescription Drugs
- Laboratory Services
- Maternity and Newborn Care
- Hospitalization (for surgeries and overnight stays)
- Rehabilitative and Habilitative Services and Devices
- Pediatric Services (including dental and vision care)
- Preventive and Wellness Services and Chronic Disease Management
- Emergency Services (including services provided at an out-of-network hospital)
- Ambulatory Patient Services (clinics, doctors office, same-day surgery centers, etc.)
- Treatment for Mental Health and Substance Abuse Disorders (counseling services and psychotherapy)
These essential health benefits are the minimum requirements for all Marketplace ACA (Obamacare) plans. They are broad categories, and the specific services that are covered vary from one state to another, depending on what that state requires.
In addition to these requirements, Qualified Health Plans must also comply with limits regarding your cost-sharing expenses (your out-of-pocket expenses) including deductibles, co-payments and annual out-of-pocket limits.
Preventive Services Covered
Preventive services are covered under the Affordable Care Act at no cost to the insured. This means there is no co-payment or deductible. There are specific services provided for all adults and specific benefits provided to women and children.
All adults can receive screening for certain cancers or diseases such as Hepatitis B & C and HIV. Screenings for things such as diabetes, high cholesterol and high blood pressure are also offered. Adults that are at a high risk for chronic disease can receive diet counseling. If you are depressed, you can be screened for that as well. Also, vaccinations are offered at no cost to all adults.
continued below ⇓
Recent Posts
Health Insurance Options For Laid-Off Workers
If you rely on employer-based health insurance and you lose your job, you may wonder what happens if you need medical care before you are able to get new coverage. Fortunately, there is COBRA, a law passed in 1986 gives many workers and their families the right to retain their health insurance even if they quit or lose their jobs.
What Are Association Health Insurance Plans?
Most people have never heard of association health plans; however, these health insurance plans have been around for decades. Association Health Plans may have fewer benefits but will most likely have lower premiums, making them an attractive option for those who are young, healthy, and on a budget.
What is the Free Look Period in Health Insurance?
To help customers avoid buyer’s remorse, health insurance policies are required to offer a free-look period. If at any time during this period you find that you’re dissatisfied with your policy, you can cancel it and get your money back.
Health Insurance Quotes
2). Online Quote
3). In Person
4260 W. Craig Road #150-A
N. Las Vegas, NV 89032
Services For Women
Because women’s health care needs are unique, some of the most common preventive services that are offered to women include:
- Contraception
- Anemia screening
- Screening for syphilis
- Screening for gestational diabetes
- Breastfeeding counseling and support
- Folic acid supplements for pregnant women
- Urinary tract infection screening and screening for other infections
- Tobacco use intervention and counseling for pregnant women who use tobacco
- Prevention and screening for pre-eclampsia for women who are pregnant and have high blood pressure
- Rh incompatibility screening for pregnant women and follow-up screening for those who are at high risk
The Affordable Care Act also covers other specific preventive services for women who are at a higher risk for certain conditions, such as breast cancer.
continued below ⇓
Search This Website
Most Popular Pages
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog
#5) Request a Quote
Services for Children
A variety of preventive services are available for children. Some of these include:
- Immunizations
- Autism screening
- Depression screening
- Behavioral assessments
- Newborn blood screening
- Oral health risk assessment
- Hearing and vision screening
- Screening for a variety of diseases including HIV and Hepatitis B
- Development screening for children younger than three years old
Let Nevada Insurance Enrollment Guide You
When choosing a health insurance plan, be sure to speak with a local, licensed health insurance agent who studies and understands Nevada health plans. This will ensure you choose a health insurance plan that best fits your needs and your budget.
Top 5 Most Popular
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Recent Posts
What is a Special Enrollment Period?
The special enrollment period is always within 60 days of a life event. A “Life Event” is an event such as the birth of a baby, losing group coverage through an employer, losing coverage due to a move to Nevada, marriage, any many other scenarios.
Using Health Insurance For Mental Health Care
The good news is that if you have an ACA compliant health insurance plan, then your health insurance covers mental health care. This removes a significant roadblock to treatment, which can be pricey.
What is a Prescription Drug Formulary?
A drug formulary is a list of the prescription drugs that your health insurance company has agreed to cover so that when you fill your prescription, you don’t pay the full price of the medication. In most cases, formularies are comprised of drugs that are the safest, most effective, and most affordable.
How To Spot Health Insurance Scams
There are numerous health insurance options and navigating the system can feel a little daunting. Unfortunately, scammers take advantage of people’s confusion by pretending to offer cheap, hassle-free help with obtaining health insurance coverage.