The required essential benefits are designed to ensure everyone in the individual and small employer group major medical health insurance markets has comprehensive coverage for specific services in accordance with ACA guidelines. These benefits are:
ACA health insurance is the federally mandated health insurance law of the land, also known as Obamacare. It governs individual and family plans and requires ten minimum essential benefits. Anyone can apply, and those that are under the 400% poverty line can receive a financial subsidy to curb the cost of their health insurance. Enrollment is available November 1-December 15 in most states. If you have a life situation that leaves you uninsured, you might be eligible for the special enrollment period to get coverage.
Short term medical insurance is not ACA insurance. It is temporary insurance for those who need immediate coverage. Like ACA insurance, Short term health insurance includes benefits such as hospital, lab and x-rays, but it does not include all ten of the minimum essential benefits and it does not cover pre-existing conditions.
Many individuals apply for both Medicare Part A and Part B so they have doctor coverage and hospital coverage. However, if you are interested in additional benefit structure and pricing, check out Medicare Advantage Plans, which is known as Part C to see if it fits for your life situation. Medicare Part C includes Part A and B benefits, but is offered through a private health insurance company instead of the federal government and may offer additional benefits and may have some other varying differences. If you take prescription drugs, it’s smart to look into Part D, which is the prescription drug benefit of Medicare.
Indemnity insurance such as a health benefit indemnity (a hospital indemnity often combined with other supplemental insurance services) is not major medical insurance Instead, it provides a cash payment directly to you (or to the provider you identify) when you experience a covered event, like unexpected hospitalization. You can choose how to use your benefit dollars and it helps defray the cost of medical expenses, both the expected like co-pays and deductibles, and the unexpected, like lost wages. Indemnity plans help protect you financially.
Dental insurance is an added benefit that is not covered by your health insurance plan. Cleanings, crowns or root canals are not covered by your health insurance plan. But dental insurance will help ease the cost of these types of medical expenses. However, unless you have employer group health insurance, dental insurance is not available unless you purchase coverage on your own. It’s a good idea to determine what kind of coverage you might need for you and your family.
Telemedicine is low-cost access to U.S. board-certified doctors who can treat symptoms and prescribe medications over the phone or through video chat, just like a visit to Urgent Care. Unlike the doctor's office, you get a personal visit from the comfort of your home 24/7, even on holidays! If you have a high deductible or don't have a doctor's office copay option on your health plan, telemedicine is much more affordable than paying out-of-pocket for a doctor's office visit that takes you away from work or home.
Health insurance can help protect you financially from the medical bills - like an accident or illness diagnosis you were not expecting. Paying for medical care out of pocket 100% can get extremely expensive. Surgical treatment for a broken arm averages $16,000. But with health insurance coverage, you will be able to manage your expenses. Not only does health insurance help you access providers like hospitals and doctors, it helps cover your expenses. Depending on your plan, you may have to meet a deductible and pay a co-pay amount for doctor’s visits, but insurance can cover a significant portion of your insurance bills. For example, the average ACA bronze level plan deductible is $5,900, but there is no lifetime max (e.g. an amount beyond which, insurance doesn’t have to pay). You can secure lower deductibles with higher level ACA plans (silver, gold, platinum) and with Short term health insurance. Short term life insurance plans do have a lifetime maximum, so if choosing a short term plan, check the amount. Often, for a few extra dollars, you can secure a lifetime maximum of $500,000 or more.
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