Learn about the benefits covered in your Marketplace plan


Before the Affordable Care Act (Obamacare), insurance companies would often cut costs by only covering certain treatments. This was often confusing and expensive for the consumer, as one couldn’t be sure that the treatment needed would be covered by their insurance policy.

With the ACA, this all changed.  There are 10 minimum essential coverage requirements that all insurance plans must meet, including:

  1. Outpatient Care: Treatment for illness or injury at a doctor’s office, clinic, or other outpatient facility.
  2. Inpatient Care: Treatment for illness or injury in a hospital.
  3. Emergency Care: Treatment for emergency illness or injury, for example, in a hospital’s emergency room (ER).
  4. Prescription Drug Coverage: Medications prescribed by your doctor.
  5. Maternity & Newborn Care: Care for mothers and babies before and after birth.
  6. Mental Health & Substance Abuse: Counseling, psychotherapy and behavioral health treatment for mental illness or substance abuse (e.g. alcohol or drug abuse).
  7. Rehabilitation: Treatment for people with disabilities, injuries or chronic illness to help them recover physical or mental skills.
  8. Lab Tests: Laboratory tests associated with treatment by a doctor or hospital.
  9. Preventative Services: Checkups, vaccines, and counseling designed to keep you healthy. Under the ACA, Preventative Services are required to be free for all plans.
  10. Pediatric (Child) Services: Dental and vision care for children, including visits to dentists and things like prescription eyeglasses.

Remember, just because plans are required to provide all these essential health benefits doesn’t mean that these treatments will be cheap. To ensure you enroll in a plan that meets your health and budget requirements, call our Consumer Advocates for support: (855) 772-2663.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s