Tobacco Surcharge On Employer Coverage?

Under the ACA you can be charged a tobacco surcharge for smoking of up to 50% of your premium after subsidies, regardless of where you get coverage. Typically won’t be charged the full amount and some insurers may not charge anything at all.

Can Health Premium Be Increased if a Claim is Made?

A health insurance premium can’t be based on health status or claims, so an insurer can’t increase premiums based on claims made. The ACA protects against discrimination based on health status. You can’t be denied or charged more based on health status or claims.

Does ObamaCare Cover Alcohol Rehab?

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.

Are Gender Ratings Illegal Under the ACA?

Gender ratings (charging women more than men or vice versa for health coverage) are illegal under the ACA, but some plans are grandfathered in and can charge more based on gender and discriminate based on health.

Grandfathered Group Plan Denying Well-Woman Visits?

I am a teacher in SC with health insurance through the state’s health plan under Blue Cross Blue Shield. This insurance does not cover an annual gynecological visit nor birth control pills. I have contacted my insurer to ask why they don’t have to cover this under the Affordable Care Act and they said they
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Prosthetic Coverage Under Obamacare

Prosthetics are covered on most ACA plans, but replacements and adjustments aren’t considered an “essential health benefit”, thus services can be limited.

ObamaCare Birth Control

ObamaCare covers one type of birth control per person from each of 18 FDA-approved categories at no out-of-pocket cost, although some plans have exemptions. This page will tell you what kinds of birth control are covered, which health plans have exemptions, how to get free birth control under the Affordable Care Act, and how to get help…

Cost Sharing on MRI?

Whether or not a treatment is subject to cost sharing is based on your plans cost sharing schedule as laid out in the plan documentation.