Everyone tells you that you have to buy health insurance because of the benefits.  However no one ever tells you what these benefits are.  You’d be surprised how much is actually covered under Marketplace health insurance plans (health plans compliant with the Affordable Care Act), and here is a complete breakdown of what is included.

Mandatory Coverage

  • Emergency treatment
  • Outpatient care: this is when you go to a hospital and are not actually admitted, but still given treatment.
  • In-patient care/surgery
  • Pediatric care (includes dental and vision – only for children)
  • Rehabilitation (injuries, disabilities, mental & physical skills)
  • Prescription drugs
  • Pregnancy & maternity
  • Mental health, behavioral services, and substance abuse
  • Preventative care and chronic illness management
  • Birth control
  • Breastfeeding

What is listed above is required by the Affordable Care Act’s minimum standards, however there are other forms of health coverage available:

  • Dental
  • Vision
  • Management programs: this includes programs to help with weight or diabetes.

If you are ever concerned over whether or not a specific healthcare service is provided, reach out to your health insurance carrier to determine your exact coverage.  If you find that your health insurance plan does not cover the services above, there are very limited circumstances for why this would be.  Consult with an attorney to confirm that your health insurance plan is covering what you contracted for.

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