Health care reform requires that all individual and small group health plans offer these 10 essential benefits starting in January 2014. Many of the benefits weren't provided or fully covered in the past, so including them means more benefits with more protection for you.
Ambulatory patient services - Care you receive without being admitted to a hospital - such as at a clinic, physician's office or same-day surgery center.
Emergency services - Care for conditions which, if not immediately treated, could lead to serious disability or death.
Hospitalization - Care you receive as a patient in a hospital, such as room and board, care from doctors and nurses, and tests and drugs administered during your stay.
Maternity and newborn care - Care provided to women during pregnancy and during and after labor; care for newly born children.
Mental health and substance abuse disorder services - Care to evaluate, diagnose and treat mental health and substance abuse issues.
Prescription drug coverage - Drugs prescribed by a doctor to treat an acute illness, like an infection, or an ongoing condition, like high blood pressure.
Rehabilitation and habilitation services and devices - Services and devices to help people with injuries, disabilities or chronic conditions gain or recover mental and physical skills.
Laboratory services - Testing blood, tissues, etc., from a patient to help a doctor diagnose a medical condition and monitor the effectiveness of treatment.
Preventive and wellness services and chronic disease management - These services include routine physicals, screening and immunizations. Chronic disease management is an integrated approach to manage an ongoing condition, like asthma or diabetes.
Pediatric services - The other nine essential benefits are provided to children along with dental and vision care.
Resources For Health Care Reform Updates - Websites To Check In With
www.KFF.org
www.AHIP.com
www.HHS.gov
www.CBO.gov
www.NAIC.org
www.statereforum.org/states
www.ncpa.org
Ambulatory patient services - Care you receive without being admitted to a hospital - such as at a clinic, physician's office or same-day surgery center.
Emergency services - Care for conditions which, if not immediately treated, could lead to serious disability or death.
Hospitalization - Care you receive as a patient in a hospital, such as room and board, care from doctors and nurses, and tests and drugs administered during your stay.
Maternity and newborn care - Care provided to women during pregnancy and during and after labor; care for newly born children.
Mental health and substance abuse disorder services - Care to evaluate, diagnose and treat mental health and substance abuse issues.
Prescription drug coverage - Drugs prescribed by a doctor to treat an acute illness, like an infection, or an ongoing condition, like high blood pressure.
Rehabilitation and habilitation services and devices - Services and devices to help people with injuries, disabilities or chronic conditions gain or recover mental and physical skills.
Laboratory services - Testing blood, tissues, etc., from a patient to help a doctor diagnose a medical condition and monitor the effectiveness of treatment.
Preventive and wellness services and chronic disease management - These services include routine physicals, screening and immunizations. Chronic disease management is an integrated approach to manage an ongoing condition, like asthma or diabetes.
Pediatric services - The other nine essential benefits are provided to children along with dental and vision care.
Resources For Health Care Reform Updates - Websites To Check In With
www.KFF.org
www.AHIP.com
www.HHS.gov
www.CBO.gov
www.NAIC.org
www.statereforum.org/states
www.ncpa.org
Jeanine Kinzie is a Licensed Health Insurance Agent, Licensed Life Insurance Agent and a Federally Facilitated Marketplace Enroller from Grand Rapids, Michigan.
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