An insurer will only pay up to an allowed amount each time you receive a covered service. There is no lifetime or annual limits to the amount they will spend doing that
What Are Essential Health Benefits? Ten Essential Health Benefits must be offered at no dollar limits on every health plan under the Affordable Care Act (ObamaCare). Essential Health Benefits consist of ten categories of items and services required for all individual and small group plans after 2014. Essential Health Benefits are the types of care… Read More
There is a loophole in TrumpCare that could result in lifetime limits and the loss of other essential benefits guaranteed by ObamaCare.
EPOs (or “Exclusive Provider Organization” plans) are plans where you can ONLY use doctors and hospitals within the EPO network, but cannot go outside the network for care. With an EPO there are no out-of-network benefits.
Covered benefits are the items your plan covers with cost sharing in it’s network. Uncovered benefits, or covered benefits out-of-network cost more. ObamaCare’s Essential Benefits vs. Covered Benefits Under the ACA all major medical plans must offer at least one covered service from ten categories of essential health benefits. That makes all essential benefits covered… Read More
Your health plan’s Summary of Benefits and Coverage (SBC) is a summary of what your plan covers in terms of benefits and cost sharing, and explanations of how everything works. We suggest opening up a Summary of Benefits and Coverage sheet as you follow along. The Summary of Benefits and Coverage PDF can be found… Read More
What is Minimum Essential Coverage (MEC)? Minimum Essential Coverage is health insurance that meets the requirements of the ObamaCare (the Affordable Care Act). This generally means coverage offers 10 essential benefits and meets actuarial value standards. Most coverage offered in the employer, private, and public markets count as Minimum Essential Coverage. Meanwhile, short-term and limited… Read More
New Benefits, Rights, and Protections in the Affordable Care Act ObamaCare offers many new benefits, rights, and protections. Most of the benefits of ObamaCare are already here, more benefits are coming. A Summary of ObamaCare’s Benefits, Rights, and Protections Benefits, rights, and protections of the Affordable Care Act (also called the ACA or Obamacare), include:… Read More
Out-of-network emergency care is covered under all insurance plans sold after March 23rd, 2010 as part of Ten Essential Benefits under the Affordable Care Act.
ObamaCare covers rehab for alcohol and drugs as part of it’s ten essential benefits. Treatment can still include cost sharing amounts and other limits.
Yes. Since cancer screenings are a preventive service (one of ObamaCare’s Minimum Essential Benefits), all ObamaCare health insurance plans have to cover lung cancer screenings. In most cases, this service must be offered at no out-of-pocket costs.
Our ObamaCare 2022 Guide: Everything You Need to Know About ObamaCare Subsidies, Rates, Dates, Enrollment, and More We cover everything you need to know about ObamaCare in 2022 including information on enrollment, assistance, benefits, plan types, and more. In this article, we’ll cover what you need to know for 2022 coverage purchased during open enrollment 2022 (Nov 1,… Read More
Our ObamaCare 2020 – 2021 Guide: Everything You Need to Know About ObamaCare Subsidies, Rates, Dates, Enrollment, and More We cover everything you need to know about ObamaCare in 2020 including information on enrollment, assistance, benefits, plan types, and more. Below we’ll cover what you need to know for 2020, and for 2021 coverage purchased in 2020. TIP:… Read More
Everything You Need to Know About ObamaCare for 2019: Information on Subsidies, Rates, Dates, Enrollment, and More We cover everything you need to know about ObamaCare in 2019 including information on enrollment, assistance, benefits, plan types, and more. NOTE: This page covers everything you need to know for 2019 up until open enrollment 2020 (which happens at the… Read More
The Trump administration is expanding short term health plans for 2019. The plans will be renewable for up to 36 months (like COBRA). The benefit is healthy Americans could pay less. However, costs are likely to be shifted to those on more robust plans.
The Trump administration announced that it will cut grants for marketplace navigators (nonprofit organizations that help people sign up for health coverage under the Affordable Care Act). The total grant reduction for these assisters under Trump has been about 80%.
A universal healthcare initiative to the people was filed in Washington State on January 23, 2018. If supporters are able to gather valid voter signatures by July 6th, 2018 (about 260,000) I-1600 will appear on the 2018 general election ballot in November. I-1600 Brief Summary of Parts I, II, III Part I creates a new… Read More
Obama had his 8 years, and “ObamaCare” had its days of being a hot topic. Today healthcare is evolving. However, the Affordable Care Act (ACA or “ObamaCare”) is still mostly in effect and a lot of the evolutions taking place rely on the structure the ACA set forth.
The Trump administration made some rule changes last year, most of those start kicking in for 2018. These include the mandate being repealed the expansion of association and short term health plans.
More people than ever will be able to find a health plan for $75 or less per month after cost assistance under the Affordable Care Act (ObamaCare).
What is ObamaCare? Understanding The Affordable Care Act (ACA) “ObamaCare” is a nickname for the healthcare law known as the Patient Protection and Affordable Care Act of 2010 (PPACA). The law is often called the Affordable Care Act (ACA) for short. Many people are aware of the basics of the Affordable Care Act (ACA). They are aware… Read More
What is the Difference Between Original Medicare and Medicare Advantage Plans? We compare Original Medicare and Medicare Advantage to help you better understand the difference between Original Medicare and Medicare Advantage plans. Both Original Medicare and Medicare Advantage are Federally regulated and ACA-compliant, but the fact that aspects of Medicare are privatized means there are significant… Read More
Short Term Coverage Vs. Major Medical Coverage Short term and major medical insurance plans both provide coverage in case of a medical catastrophe, but they have significant differences. Short-term plans are typically used to fill in the gaps between major medical coverage. They act as a temporary coverage and often offer lower premiums for less… Read More
Trump likely just made health insurance cheaper for some with his executive order on association plans and short term insurance. We look at the pros and cons.
The facts below are our original “ObamaCare facts” page. These ObamaCare facts will give you a sense of how things used to be and what has changed. See our up-to-date “ObamaCare” facts page here. It is easy to forget that time when women paid more than men for health insurance, or when you could be denied… Read More