List Headline Image
Updated by Blue Cross NC Asheville on Nov 28, 2017
Headline for 10 Essential Health Benefits Guaranteed Under the Affordable Care Act
 REPORT
10 items   2 followers   0 votes   10 views

10 Essential Health Benefits Guaranteed Under the Affordable Care Act

In order for a health insurance plan to be compliant with Health Care Reform, it must cover ten minimum essential health insurance benefits, as mandated by the Affordable Care Act. Our personal reform advisors will help you understand the types of coverage offered by each plan, and will assist you in finding a plan and health insurance quote with the lowest premium and the most health insurance benefits for your family.

All individual or group health insurance plans offered through WNC Health Insurance / The Asheville Blue Cross and Blue Shield of North Carolina® Store are Affordable Care Act compliant and provide coverage for these required ten minimum essential health benefits:

1

Ambulatory Patient Services (outpatient services, labs, and testing)

Ambulatory Patient Services (outpatient services, labs, and testing)

This is also referred to as outpatient services. This is treatment that is received without being admitted to a hospital, including doctor’s office visits or minor surgery at an outpatient center

2

Emergency Services

Emergency Services

This covers coverage for emergency situations that require a visit to the emergency room, such as heart attack symptoms or a car accident.

3

Hospitalization

Hospitalization

This coverage includes hospital care from doctors and nurses along with any surgeries or tests performed while admitted. These benefits will be limited.

4

Maternity and Newborn Care

Maternity and Newborn Care

This includes all treatment related to pregnancy, which includes: prenatal care, childbirth, and newborn care.

5

Mental Health and Substance Use Disorder Services

Mental Health and Substance Use Disorder Services

Care related to mental health issues and addiction services such as: outpatient behavioral treatment, including: counseling and therapy, along with any related inpatient care.

6

6. Prescription Drugs

6. Prescription Drugs

ACA plans are required to cover at least one prescription drug from every class and category of federally approved drugs.

7

7. Rehabilitative Services and Devices

7. Rehabilitative Services and Devices

This covers all services and devices that assist people with injuries, disabilities, or chronic conditions to help gain or recover mental and physical skills.

8

8. Laboratory Services

8. Laboratory Services

These services include tests performed by your doctor in order to provide a diagnosis or to monitor treatment.

9

Preventive Wellness Services and Chronic Disease Management

Preventive Wellness Services and Chronic Disease Management

This category of services includes: annual checkups, a colonoscopy, immunizations, preventative screenings, as well as treatment for chronic diseases, such as diabetes.

10

Pediatric Services, including Oral and Vision Care

Pediatric Services, including Oral and Vision Care

Plans are also required to cover routine pediatric care, including wellness visits, vaccines, and immunizations, as well as vision and dental care for children.