The insurance mandate under the Affordable Care Act (ACA) will require that most Americans carry health insurance by January 2014. Among the goals of the ACA has been to ensure that people receive comprehensive coverage, and several provisions have been incorporated into the ACA to that end, including a rule that prevents insurance companies from denying or canceling a person’s coverage due to preexisting conditions.
Another provision to protect consumers is the Essential Health Benefits rule that requires health plans both inside and outside the health insurance marketplace to cover basic services deemed essential to health. They include:
- Ambulatory (outpatient) patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral* and vision care
*The pediatric dental services provision was recently lifted, and these benefits will no longer be required to be part of qualified health plans.
The inclusion of the essential health benefits will help ensure that people get the basic services they need for optimal health.
Benefit Packages is a full-service agency that has been helping individuals, families and businesses find comprehensive health benefits in California for over two decades. Benefit Packages will be Exchange Certified to help you find the best coverage possible, whether inside or outside the California health insurance exchange. Visit our website to learn more about the healthcare mandate and whether you qualify for coverage through the exchange, or call us at 1-800-356-3615.