Laboratory Services is the eighth listed Essential Health Benefit in the Affordable Care Act. Doctors order lab tests to help them diagnose an acute illness or to monitor the effectiveness of their treatments of chronic conditions. They also order tests for documentation in case of a lawsuit.
- analysis of bodily fluids (You know – blood, urine, sputum, etc.)
- phlebotomy (drawing blood)
- Maintaining a blood bank
- pathology (examination of tissue samples.)
Other tests such as imaging with X-Rays, Ultrasound, CT scans, and MRI’s are not generally included in laboratory services. But don’t worry, the next essential health benefit – Preventive and wellness services and chronic disease management – will probably take care of seeing that they are covered, too!
Apparently because the prices charged for these tests can amount to significant figures, those writing the law felt insurance benefits should include some coverage for these services. Rates for premiums will, therefore, include a component that covers the company’s plan for laboratory services coverage. Which services will be covered and what copays and deductibles will be required will depend on the rules set up in the state you live in – and the company you purchase from.
You should be able to find out what is available for you by getting on the government’s website healthcare.gov and viewing the health care plans available for you. If your state has its own exchange, you will be referred to it for that information. Another option is to go to a local insurance agent. Or you can use one of the private health insurance marketplaces on the web like eHealthInsurance.com. They are up and running, have free consultants to answer your questions and help you through the process of evaluating, choosing, and applying for affordable health care insurance. Especially if you have a chronic health condition that requires frequent monitoring for lab values, you will probably want to talk with an expert about what level of laboratory services benefits you can include in the plan you buy.