Health Insurance

Health Insurance Coverage Minimum Standards

The Affordable Care Act requires that each state set minimum health insurance standards for qualifying health insurance plans. After January 1, 2014, you will be responsible for carrying health insurance that meets the minimum standards set by your state. We’re here to help you find insurance that meets your needs and the needs of your family, including finding health insurance that meets the minimum health insurance coverage standards set by your state.

Why This Is Important

It’s often difficult to tell exactly which health benefits are covered by a health insurance plan. In addition, insurance providers can sell health plans that don’t provide important health benefits. All too often, people only find out what their health insurance doesn’t cover when they need a prescription, a lab test or a procedure – and their insurance company denies payment. The ACA addresses both of those problems by requiring that health insurance plans cover “essential health benefits.”

What Health Insurance Coverage Is Required?

The actual level of benefits will be determined on a state-by-state basis. Each individual or small group insurance policy will be required to provide some level of health insurance coverage in each of the following 10 areas.

Ambulatory Patient Services

Emergency Services

Hospitalization

Maternity and Newborn Care

Mental Health and Substance Abuse Services

Prescription Drugs

Rehabilitative and Habilitative Services and Devices

Laboratory Services

Preventive and Wellness Services and Chronic Disease Management

Pediatric Services Including Oral and Vision Care

What If I Want More Health Insurance Coverage?

Insurance companies can offer plans with many different levels of benefits, including bare-bones catastrophic health insurance and insurance plans that provide much higher levels of benefits for members. You’re always free to choose a higher-value plan, or to buy supplemental health insurance policies that add to the defined benefits of your health insurance policy.

How Do I Know What’s Covered?

We make it easy for you to choose just the right health insurance coverage for your family. You’ll find every type of health insurance coverage you’ll need here, including individual health insurance, family health insurance plans, high-deductible health insurance to use with a Health Savings Account, Medicare supplement insurance, dental care insurance, vision care insurance and supplemental health insurance of all types. Talk to an experienced health insurance professional to help you decide which plan offers the best health insurance coverage for you and your family. You’ll find real peace of mind when you know your family’s health care needs are covered.

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