Falling sick is never in our hands, but taking precautions to avert illnesses is essential. People living in the US continuously live with the fear of going bankrupt if they have to undertake medical care. Anything from a visit to the doctor, to the prescribed drugs, or even screenings and lab tests can cost a fortune in this country.
If you are covered under health insurance plans, you can relax a little. In case you are not, you will never be able to pay up the incredibly high costs of surgery, emergency cares, or a visit to the hospital- unless you are some kind of a millionaire.
Thanks to Patient Protection Affordable Care Act (PPACA) or ACA, implemented in 2010, a huge number of Americans again started buying health insurance these days. Moreover, it’s the health insurance marketplace that offers a plethora of high-quality health plans. Using these marketplaces, you are actually able to afford the highly expensive medical facilities.
Who are all eligible to get health insurance benefits from the marketplace?
To be eligible, you have to be either, or:
Citizen of the USA
National of the USA
Your eligibility ends, if you:
Do not have legal immigration document
Once you find your eligibility, it is always better to buy a health insurance that suits you from the marketplace.
There are many, but listed here are 14 health insurance benefits that the health insurance marketplace provides to every eligible individual and their family:
1. Those situations that warrant the need for emergency facilities
2. In case you need to be an in-patient- admission into a hospital or nursing home.
3. Out patient department- certain health situations do not force hospitalization, yet medical assistance from a physician gets necessary. Even as out patients, your health insurance plan will cover you if you have visited the physicians who are in-network with the plan you chose.
4. Earlier, any kind of mental imbalance like paranoia or schizophrenia was not covered by any healthcare provider. Post the implementing of Affordable Care Act (ACA), mental illness or substance abuse, or even behavioral therapy is covered. In case you or someone in your family needs psychiatric or psychological counseling, care or hospitalization, the marketplace will have to assist you through your health insurance plan.
5. If you are under the perception that prescription drugs can be affordable outside a health insurance plan, you will be fully surprised. For certain medicines prescribed, you will need the assistance of the exchange in sharing the cost of those medicines.
6. Women particularly need to get themselves checked for two major types of cancer. Chances are, cervical and breast cancer may show up after a long time being dormant in a female hormone. A proper screening is essential to prevent it from getting fatal. Tests for cervical cancer detection and breasts are also covered by health coverage packages post ACA.
7. Certain health conditions may not require hospitalization, but one may need to undergo a prolonged period of therapies for its cure. The health insurance marketplace provides assistance for cases of individuals requiring speech therapy, physiotherapy, psychological counseling, etc.
8. In case of pregnancy, child birth and post delivery period- all the medical costs can be shared by your health insurance provider.
9. Lab tests- various kinds of tests like, blood sampling, x-rays, ECG, EEG, etc.
10. For those who are senior citizens and need geriatric care, different healthcare subsidies are also provided to them.
11. Pediatric health care- including dental and visual care- ACA provides huge subsidies through Child Health Insurance Plan (CHIP).
12. ACA allows children to stay on their parents’ plan till they turn 26.
13. Preventive services- Certain diseases like polio, dengue etc. can be prevented using vaccines, counseling, or screenings, etc. Marketplace covers all these preventive services within their health insurance plans.
14. If you fall under 133% to 400% of the Federal Poverty Level (FPL), you are eligible for Medicaid and Medicare, depending upon the income of your family of 4 people.
Benefits of health insurance marketplace coverage
The benefits include coverage for pre-existing conditions, doctor visit, laboratory tests, surgery, hospitalizations, and emergency care. A few more benefits that the health insurance marketplace provides are:
Services related to substance abuse and mental health– The department of psychology and psychiatry, which was otherwise not covered under health insurance plans have now been included into the marketplace. Behavioral therapies requiring counseling and psychotherapy also receive coverage.
During maternity, you will be provided all the healthcare facilities even if your coverage period has not yet started. Moreover, there are plans that help you receive benefits during breast feeding.
Women get special benefits in their preventive care like examinations and child prevention medicines (contraceptives). Moreover, preventive services are covered under the marketplace for children, adults, and women.
While falling ill is something we cannot control essentially, thanks to the health insurance marketplace in the US, a lot of people are actually able to afford healthcare. Earlier, it was the Medicare and Medicaid which came to rescue all those American citizens who could not afford medical costs. Since 2010, after ACA was implemented, a huge number of people have been able to afford healthcare services.