With the Affordable Care Act, all ACA-compliant health insurance plans (aka Obamacare or ACA plans) must include Essential Health Benefits (EHBs). There are ten categories of EHB services that these plans must cover.
To see prices and available Marketplace plans that cover the 10 essential health benefits, log into Inshura.com.
The 10 Essential Health Benefit Categories are:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drug coverage
- 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 (however, adult dental and vision coverage are not essential health benefits)
All ACA-compliant plans must also include birth control coverage and breastfeeding coverage. This means that any health care plan you buy off the health insurance Marketplace, like Inshura.com, comes with a guarantee that your plan will include coverage for all of the above types of services, even though details on specific services may vary by plan. ACA-compliant plans also cover Covid-19 testing.
Preventive Care is also included
One key thing to keep in mind is that any of the above Essential Health Benefits that are considered preventive care, versus diagnostic care, are also covered at no-cost thanks to the Affordable Care Act. There are 65 free healthcare services guaranteed by the Affordable Care Act in any ACA-compliant plan. This is true of any plan you purchase off the Marketplace, through Inshura.com, or that you have through an employer who offers ACA-compliant benefits. Preventive care is not always covered by health sharing ministries, short-term insurance, or indemnity plans.
Please remember that you will need to see an in-network provider to receive these preventive services at no cost to you. To see health insurance plans and prices that are available, log into Inshura.com.
What are all of the health insurance options?
You have several coverage options for plans that cover all of the EHBs.
- Marketplace plan. You can enroll in a Marketplace health insurance plan, also known as Obamacare or Affordable Care Act insurance. See plans and prices when you log into Inshura.com.
- Medicaid. You also may be eligible for Medicaid, depending on your income. You can check eligibility and apply here.
- COBRA. If you’ve been laid off recently, you usually have the option of COBRA, where you pay the full premium of the same insurance your employer purchased for you. COBRA is typically much more expensive than Marketplace insurance, but it allows you to continue the coverage you already had.
- Medicare. Once you turn 65, you’re eligible for Medicare. Log into Inshura.com to enroll.
When is enrollment for Marketplace health insurance?
Anyone who’s eligible can enroll in Marketplace health insurance during Open Enrollment, which runs from November 1 to January 15 in most states. If it’s outside of that period of time, you’ll need a Qualifying Life Event, such as losing your insurance or having a child, to qualify.
Inshura is a FREE online ACA insurance tool, perfect for agents and agencies! Agents can boost their ACA and other enrollments using this easy-to-use solution for quoting, enrolling, automating renewals, and managing clients!
And inshura is CMS EDE PHASE III certified, so it automatically exchanges data directly from the Marketplace.