With the passage of the Affordable Care Act on March 23, 2010 the entire healthcare industry in the United States changed forever. The greatest impact will be felt by individuals, families, small business and part time employees of large companies (those who work less than 30 hours per week).
While a majority of Americans receive insurance through either their employer or through the government via Medicare and Medicaid, everyone else will be required to purchase health insurance coverage effective January 1, 2014 or face penalties.
Many Americans who earn less than 400% of the Federal Poverty Level may qualify for premium assistance through government subsidies. Those who earn more than 400% of the Federal Poverty Level will be responsible for paying full premiums.
With the passage of the Affordable Care Act, all private health insurance plans offered in the Marketplace are required to cover 10 essential health benefits:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (such as surgery)
- Maternity and newborn care (care before and after your baby is born)
- Mental health and substance use disorder services, including behavioral health treatment (this 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
With health insurance companies offering similar plan benefits, the primary differentiation between plans comes down to doctor networks and covered medical facilities.
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