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No matter what kind of coverage you have, it’s important to know what’s covered and what’s not. Starting in 2014, certain essential health benefits will be covered under all policies. In the meantime, the new law offers new options for preventive coverage and insurance for those with pre-existing health conditions.
Nothing in the new law restricts access to those services provided by IHS. It’s simple: if you had access to a local IHS, tribal, or urban clinic, you can still go there. You will have access to the same services as before at the same level. There is no reason to worry about decreased services or longer wait periods due to changes under health reform. In fact, under the new law, IHS, tribal and urban clinics will have greater incentives to serve more patients with greater efficiency.
It depends on what policy you buy. Coverage under many individual policies today can be very limited. This will change.
Starting in 2014, new individual plans and plans purchased in an Affordable Insurance Exchange will have to cover essential benefits like hospitalizations, doctor services, prescription drugs, rehabilitation and mental health services, pregnancy, and newborn care. Also, there will be limits on how much you have to pay out-of-pocket each year for covered services.
An Affordable Insurance Exchange is a new marketplace where individuals and small businesses can buy affordable health benefit plans. Exchanges will offer you a choice of plans that meet certain benefits and cost standards.
Coverage for Preventive Care
Under the Affordable Care Act, new health plans must cover certain preventive services without cost sharing.
Coverage for Pre-Existing Conditions
Coverage for Pregnancy under Job-Based Plans
Under your job-based plan, pregnancy cannot be considered a pre-existing condition. In addition, newborns and adopted children who are enrolled within 30 days of birth or adoption cannot be subject to a pre-existing condition exclusion.
Read your policy. Often this is hard to do. Insurance policies can be complex documents and not always easy to follow. Call your insurance company for more information about what your policy covers.
Starting in 2012, all insurance papers must be written in clear and understandable language that explains what’s covered and how it works, so you can understand your choices more clearly and decide what coverage is really best for you.
Health Plan Summaries
More Information on What’s Covered