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Essential Health Benefits of The Affordable Care Act

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Essential Health Benefits of The Affordable Care Act

Now that the Affordable Care Act (ACA) has been in around for a little over a year now, have you noticed that some health services are now being covered which were not covered in your previous health plan? This is due to ACA requiring all health insurance plans include what is now known as Essential Health Benefits.

Essential Health Benefits contain standards to protect consumers from discrimination and guarantee that all health plans comply with the standards of The Affordable Care Act. This includes plans for individual and group health insurance, such as Platinum, Gold, Silver and Bronze plans where the insurance provider must offer a core set of benefits as required by ACA

Health services are free for annual preventative care and wellness visits ( 1 for men, 2 for women each year) without any co-pays or coinsurance but other benefits will not be covered until you meet your health plan deductible.

Although all health plans must cover the minimum essential benefits with no annual dollar caps, higher premium plans such as Platinum and Gold cover more non-essential benefits with less cost sharing.

What Are The 10 Essential Health Benefits?

Essential health benefits must include items and services within at least the following 10 categories:

1.Outpatient care—the care you receive without being admitted to a hospital
2.Ambulatory Care: Trips to the emergency room
3.Treatment in the hospital for inpatient care
4.Maternity Care: Before and after your baby is born
5.Mental health and substance use disorder services: This includes behavioral treatment, counseling, and psychotherapy
6.Prescription drugs
7.Rehabilitative Devices: Services and devices to help you recover from injuries, disabilities or a chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more
8.Laboratory Services. Your lab tests are covered
9.Preventive services: Includes counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease
10.Pediatric services: This includes dental care and vision care for kids

You can compare the available Essential Health Benefit Plans, Platinum, Gold, Silver and Bronze for your small business by going here: Healthplansny Quick Quotes