ACA / Obamacare
The Affordable Care Act (ACA), also known as Obamacare, has helped millions of people get health care coverage through governmental assistance with paying for monthly premiums and out-of-pocket costs. Additionally, those who have pre-existing medical conditions can longer be denied coverage.
Beginning January 1, 2014, all major medical plans must be ACA certified. This means they must provide specified essential health benefits (EHB) and follow established limits on cost-sharing such as deductibles, copays, and out-of-pocket maximums. Qualified plans can be purchased "On" or "Off" the Marketplace Exchange. Depending on age and income, consumers may be eligible for tax credits to help pay for "On" Exchange plans.
The ACA requires certified health plans to cover the following 10 essential health benefits:
1. Ambulatory patient services
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services including behavioral health
treatment
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventative and wellness services and chronic disease management
10. Pediatric services, including oral and vision care