These are the 10 Essential Health Benefit Categories:
- An ambulatory patient service is outpatient care you receive without being admitted to a hospital.
- Services for emergencies.
- Hospitalization (such as surgery and overnight stays)
- Maternity, newborn, and pregnancy care (before and after birth).
- A wide range of mental health and substance use disorder services, including counseling and psychotherapy.
- Coverage for prescription drugs.
- Services and devices that help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills.
- Services provided by laboratories
- Services related to prevention, wellness, and chronic disease management.
- Dental and vision care for children (adult dental and vision coverage is not an essential health benefit).
ACA-compliant plans must also offer birth control and breastfeeding coverage. Regardless of the specific details on specific services, all health care plans purchased through the health insurance Marketplace, such as TrueCoverage.com, are guaranteed to cover all of the above types of services. Covid-19 testing is also included in ACA-compliant plans.
Also included is preventive care
It is important to remember that the Affordable Care Act guarantees no-cost coverage of any Essential Health Benefits designated as preventive care. There are 65 such services covered by ACA-compliant plans, whether you purchase a plan through the Marketplace, TrueCoverage.com, or through your employer’s ACA-compliant benefits. These services may not be provided, however, when it comes to health sharing ministries, short-term insurance, or indemnity plans.
You must see an in-network provider to receive these preventive services at no cost. To find out which plans and prices are available, log onto TrueCoverage.com.
Which health insurance options are available?
For plans that cover all EHBs, you have several options.
When you log into TrueCoverage.com, you can see plans and prices for Marketplace health insurance plans, also known as Obamacare or Affordable Care Act insurance.
- Depending on your income, you may also be eligible for Medicaid. Check your eligibility and apply online.
- Usually, if you have been laid off recently, you have the option of COBRA, which requires you to pay the full premium for the insurance your employer provided. Despite being much more expensive than Marketplace insurance, COBRA allows you to keep your existing coverage.
- TrueCoverage.com allows you to enroll in Medicare once you turn 65.
What is the deadline for Marketplace health insurance enrollment?
In most states, Open Enrollment runs from November 1 to January 15, and anyone who is eligible can enroll in Marketplace health insurance. You must have a Qualifying Life Event, such as losing your insurance or having a child, to qualify if it is outside that time frame.
