ObamaCare Facts

More Social Consequences of Obamacare

Health Insurance Policy On Hold

Another of the ‘unanticipated’ consequences of ObamaCare has hit the news. If you still don’t have health insurance, you may not be able to buy it until next year. It seems that insurance companies across America have stopped making individual health insurance plans readily available on a year-round basis. Read more »

Essential #10 – Pediatric Services

group of smiling multiracial children

Essential #10 – Pediatric Care We’ve come to the last on the list of essential health benefits in the ‘ObamaCare’ Affordable Care Act. The exact wording in the act requires “Pediatric services, including oral and vision care.” This requirement looks pretty straight forward  – In order for you to be considered insured by a ‘qualified health plan’, your policy must include coverage for children. But, you guessed it – There are a couple of things […] Read more »

Essential Benefit #9 – Preventive, Wellness & Chronic Disease Benefits

Getting immunization from vial

So, this is the ninth on the list of Obamacare’s ten essential health benefits. In some ways it seems to include three separate categories of health services. Preventive Services Wellness Services Chronic Disease Management Let’s look at each of them. Preventive Services Preventive services sounds like things that keep you from getting sick, doesn’t it? And most of the things that keep us from getting sick are either environmental – like clean air and clean […] Read more »

Essential #3 – Hospitalization Insurance Benefits

Sign with white H on blue

Aha! This is one of those benefits that we expect all major medical insurance policies to cover – at least to some extent. And it is the third of the 10 essential benefits listed in the Affordable Care Act. Your hospitalization insurance is generally designed to pay a good portion of the costs related to an illness or injury so bad that your doctor feels you need to stay in the hospital for care. However, […] Read more »

Essential Benefit #8 – Laboratory Services

Lab tech doing test with dropper

  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. Laboratory services can include: analysis of bodily fluids (You know – blood, urine, sputum, etc.) phlebotomy (drawing blood) Maintaining a blood bank pathology (examination of tissue samples.) […] Read more »

Essential #7 – Disability Services

Man in suit with a walker

Number 7 on the list of Obamacare’s Essential Benefits is Rehabilitative and Habilitative Services. In case you’re wondering, as I was, just what that means, here’s what I can tell you. They are basically Disability Services but we give them different names depending on when and how you got your disabilities. Rehabilitation, as you probably know, involves helping people regain skills they had already developed but somehow lost. Well, ‘habilitation’ is helping people gain skills […] Read more »

Essential #4 – Maternity and Newborn Care

clip art of pregnant couple on couch

The fourth of the 10 essential benefits listed under Obamacare is Maternity and Newborn Care. Surely this is a fairly straight forward benefit isn’t it? Healthy mothers and babies are good for society. And that means that all mothers and babies need to have access to good medical care – which can be guaranteed if all health insurance plans include maternity and newborn care provisions. But this benefit isn’t as straight forward as it initially […] Read more »

Essential #6 – Prescription Drug Coverage

Rx made out of pills

Prescription drug coverage is sixth on the list of the ‘Essential Health Benefits’ that must be included in every health insurance plan according to the Affordable Care Act. So what is this going to cover? Well, prescription drugs are those medicines you use that you can’t buy off the shelf at the store. This benefit should help with their cost but just which drugs are covered and at what cost is not clear. Don’t expect […] Read more »

Essential #5 – Mental health and substance use disorder services, including behavioral health treatment

graphic - colored brain

Here is an interesting provision that may challenge those defining its meaning(s). Admittedly, there are a significant number of Americans that really need it who aren’t getting adequate mental health care. But how far is Ms. Sebelius’s office going to go in requiring insurance companies to cover mental health diagnoses? The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders with specific guidelines for defining mental disorders was just published in May […] Read more »

Essential #2 – Emergency Services

Ambulance at Emergency Entrance

The second of the 10 essential benefits listed in the Affordable Care Act is ‘Emergency Services.’ So just what does ‘Emergency Services’ include? Well…Hospital Emergency Room care, for sure. And most likely EMS (Emergency Medical System) care when first aid, paramedic, or rescue services are called for. And, I suppose ambulance transportation – at least in an emergency. Like the first ‘essential benefit,’ it is far from clear just how much clients can expect insurance […] Read more »