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.
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How Financing Your Car Affects the Insurance Premium
However, you may end up paying a higher premium than someone who has not financed their vehicle. If you make payments on your vehicle, your lender requires you to have comprehensive and collision coverage on top of the state minimum requirements.
Adding Uninsured / Underinsured Motorist To Your Policy
Uninsured and underinsured motorist coverage is used when you are hit by a driver that has insufficient coverage or no coverage at all. This optional coverage helps to compensate you for damages, up to your policy limit.
What Is Renters Insurance?
Renter’s insurance covers your personal property. If your property is damaged due to a covered peril such as a fire or theft, then you are compensated for your loss up to your policy limits. There are a variety of risks and events covered by renters insurance.
Health Insurance Quotes
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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.
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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.
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Recent Posts
At Fault – If You Caused an Auto Accident
The responsibility of who pays what in Nevada is contingent on who’s at-fault in an auto accident. All drivers in Nevada have an obligation to drive their automobiles safely to reduce any risks of potential accidents. In Nevada, if you are the at-fault driver (the person that caused the accident), then you are responsible to “make whole” the individual or property you hit.
I Witnessed A Car Accident; What Do I Do?
A car accident can happen in the blink of an eye and witnessing one can be scary. After an auto accident, all drivers involved are required to stay at the scene where information is exchanged for auto insurance purposes. But what should you do if you witness a car wreck?
Accidents / Vandalism: Does Auto Insurance Cover Personal Belongings?
Personal items such as a tablet, wallet, or any personal valuables are not generally covered in your auto insurance policy. Those items would be covered in your homeowners/renters policy. You would have a deductible to pay for first, and then you’d need to consider the consequences of a claim on your homeowners policy.
Windshield / Glass Coverage
Windshield / glass coverage pays the amount of a covered glass loss, and as an added perk, it has a low deductible. Your insurer will cover the full costs of the repairs up to your policy limit, and as long as the costs of the damages don’t exceed your coverage limit, you’ll pay only your small deductible.