It's time to start looking for a health plan for 2021. Annual open enrollment for Obamacare started on November 1 will ends on December 15, in most states except few states where there is an extended period to enroll.
a. Depending on your income, you may qualify for an insurance plan with tax credits or,
b. Medicaid and the Children’s Health Insurance Program (CHIP) which provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
All marketplace plans cover ten essential health benefits:
• Ambulatory patient services
• Emergency services
• Pregnancy, maternity, and newborn care (both before and after birth)
• Mental health and substance use disorder services, including behavioral health treatment that includes counseling and psychotherapy
• Prescription drugs
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care (but adult dental and vision coverage are not essential health benefits)
All Marketplace plans cover contraceptive methods and counseling for women, as prescribed by a health care provider. The plan covers FDA-approved contraceptive methods including:
• Barrier methods, like diaphragms and sponges
• Hormonal methods, like birth control pills and vaginal rings
• Implanted devices, like intrauterine devices (IUDs)
• Emergency contraception
• Sterilization procedures
• Patient education and counseling
Plans are not required to cover drugs to induce abortions and services for male reproductive capacity, like vasectomies.
Marketplace plans cover breastfeeding equipment and counseling for pregnant and nursing women. including help with breastfeeding at no extra cost. Your health insurance plan will cover the cost of a breast pump. It may be either a rental unit or a new one you will keep. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when you will receive it either before or after birth.
Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements. Plans may offer additional benefits, including:
Dental coverage is available as part of a health plan or you may buy a dental plan separately as stand-alone. If a health plan includes dental, the premium covers both health and dental coverage. If you choose a separate dental plan, you will pay a separate, additional premium.
Under the health care law, dental insurance is treated differently for adults and children 18 and under.
• Dental coverage is an essential health benefit for children. This means if you are getting health coverage for someone 18 or younger, dental coverage must be available for your child either as part of a health plan or as a stand-alone plan. Note: While dental coverage for children must be available to you, you do not have to buy it.
• Dental coverage is not an essential health benefit for adults. Insurers do not have to offer adult dental coverage. (source: healthcare.gov)
• A health benefit that at least partially covers vision care, like eye exams and glasses. All plans in the Health Insurance Marketplace® include vision coverage for children. Only some plans include vision coverage for adults.
• If adult vision coverage is important to you, check the details of any plan you are considering.
• If your plan does not include adult vision coverage, you can buy a “stand-alone” vision plan to reduce your vision care expenses. The Marketplace does not offer stand-alone vision plans. To shop for stand-alone vision plans, contact an insurance agent or broker, or search for plans online. (source: healthcare.gov)
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