Marketplace coverage & essential health benefits
Health marketplace insurance is a resource where an individual can compare health insurance for coverage and affordability as well as enrol in a health insurance plan that meets the individual's requirements. There are many health benefits associated with this. Through this article, we will walk you through the ten essential health benefits that various private health insurance plans offer in health insurance marketplace coverage.
Ambulatory care: Ambulatory patient services or outpatient care is a medical care service which includes diagnosis, treatments, consultations, etc. without being admitted to the hospital.
Emergency services: In case of an emergency, you should be able to get medical attention from the hospital near you. The hospital will help you whether you have insurance or not. The insurance company will not be able to charge you for emergency room services at an out-of-network hospital.
Hospitalisation: Hospitalisation insurance includes overnight stays at the hospital, surgery, etc.
Maternity care: Health benefits are included during pregnancy, childbirth as well as the new-born both before and after birth.
Mental health and substance abuse: All plans must include psychotherapy and counselling, mental and behavioural inpatient services, and substance use disorder treatment.
Rehabilitative and habilitative services and devices: Here there are services and devices offered to help those who have suffered due to an injury, or chronic disease, or to help recover their mental or physical state. Health insurance and benefits also include prescription drugs.
Laboratory services: This is where a laboratory will carry out clinical tests to get information about the health of the patient to aid in treatment and prevention of disease. Prevention and wellness services and chronic disease management: Various health insurance plans must cover a set of preventative services such as shots, screening tests, etc. without charging the policyholder. Paediatric services: These services include oral and vision care, however, adult dental and vision care are not essential health benefits. What else does marketplace cover?
Marketplace plans should also include birth control and breastfeeding coverage. Health insurance plans should include contraceptive methods and counselling for all women. Health insurance plans must also provide breastfeeding support, counselling, and equipment during the course of breastfeeding for pregnant and nursing women.
Essential benefits are a minimum requirement for every marketplace plan. There are some specific services that are covered in each broad category. These can vary depending on where you live. Some plans also offer other benefits such as dental and vision coverage.
In marketplace, you can either pick a health insurance plan that does or does not include dental coverage. If you opt for a plan without dental benefits, you can still opt for a separate dental plan.
All health insurance plans include vision coverage for children and only some offer it to adults. If vision coverage is a necessary requirement for you, you can buy a vision care plan to cut back on your expenses.
Lastly, one other benefits include is medical management programs. These are so specific types of people who are in need of weight management, back pain, diabetes, etc.
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