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
Nevada Insurance Requirements for Vehicle Registration
Confused about insurance requirements for vehicle registration in Nevada? Learn why auto insurance is mandatory, with minimum liability coverage of 25/50/20. Understand how to provide proof, navigate the registration process, and avoid costly lapses. From required documents to penalties, this guide covers it all. Discover optional coverages and cost-saving tips to stay protected.
What Is a Health Insurance Carrier?
A health insurance carrier provides plans to cover medical expenses, like doctor visits and prescription medications. Understanding your insurer’s network, plan types (HMO, PPO), and costs (premiums, deductibles) is key to choosing coverage. In Nevada, carriers collaborate with Nevada Health Link to offer ACA-compliant plans, ensuring access to preventive care and essential benefits. Learn how to select a dependable health insurance company and manage costs effectively.
What is a Prescription Drug Deductible?
In the world of health insurance, “deductible” is a common word. It refers to an amount of money that you pay out of your pocket before the insurance company begins to pay. A prescription deductible is the portion you’d pay first, then after you’ve paid the deductible, you may only have to pay a co-pay when you pick up your medication.
If you are single, you would only have to meet your prescription deductible. If you have two or more people in your family, each member may have to meet their own prescription deductible which could be up to 2 deductibles in the family. A prescription deductible is different and separate from the medical deductible, unless otherwise stated. One deductible is for medical, ie: hospitalization, doctors, etc., and the other deductible is for filling your prescriptions.
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 Prescription Drug Deductible?
In the world of health insurance, “deductible” is a common word. It refers to an amount of money that you pay out of your pocket before the insurance company begins to pay. A prescription deductible is the portion you’d pay first, then after you’ve paid the deductible, you may only have to pay a co-pay when you pick up your medication.
If you are single, you would only have to meet your prescription deductible. If you have two or more people in your family, each member may have to meet their own prescription deductible which could be up to 2 deductibles in the family. A prescription deductible is different and separate from the medical deductible, unless otherwise stated. One deductible is for medical, ie: hospitalization, doctors, etc., and the other deductible is for filling your prescriptions.
Are Ambulance Rides Covered By Health Insurance?
If you have a qualified health plan (QHP) the answer is yes, ambulance rides are covered. A QHP is an insurance plan that is certified by Nevada Health Link in Nevada that covers “10 essential health care benefits” including emergency transportation. You may need to pay a deductible, co-payment, or co-insurance for your ambulance trip.
Does My Auto Insurance Policy Cover My Trailer?
You have an auto insurance policy that covers damage to your vehicle, but what if you regularly use your vehicle to pull your trailer? Does that trailer have the same coverage as your car or truck?
What Is a Qualified Health Insurance Plan?
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. Qualified Health Plans MUST cover these 10 items without any lifetime or annual limits on these “Essential Health Benefits.”