Not all plans are created equal. This year, you might come across some health insurance plans that won’t cost you much—keep in mind they won’t cover much either.
Under the Affordable Care Act, all Health Insurance Marketplace plans are required to cover what are called the ten essential benefits. These benefits include:
- Ambulatory services, or outpatient care (e.g. emergency visits, diagnoses)
- Emergency services (e.g. ambulance call)
- Hospitalization (e.g. surgery, overnight stays)
- Maternity and newborn care (e.g. newborn screenings, maternal depression screening)
- Mental health services (e.g. counseling, substance use disorder treatment)
- Prescription drugs
- Rehabilitative services and devices (e.g. physical therapy, prosthetics)
- Laboratory services (e.g. blood tests, urine tests)
- Preventive services (e.g. immunizations, cancer screenings)
- Pediatric services (e.g. immunizations, oral health care)
Keep in mind that different plans might cover different providers or prescription brands. If you want specific prescriptions, providers, or services to be covered, double check the plan you’re thinking about enrolling in. “In-network” providers are providers who have contracted with a health insurance company and should be covered by your plan. Most plans will at least cover generic brands of prescriptions.
All health insurance plans sold through Healthcare.gov will cover the ten essential benefits, and they won’t require you to provide extensive information about your health history when you apply. If you’re filling out an application and find that you’re being asked a lot of questions about your health, you might be applying for a short-term or temporary health insurance plan. These plans might seem more appealing at first glance, but they won’t give you the benefits and protection that Marketplace plans will.
Health insurance might seem like a big cost, but investing in coverage can help protect you from expensive medical bills down the road. No one plans to get ill or injured, but life is unexpected. Even if you’re well now, your health can change. Make sure you choose a plan that will have you covered no matter what.
