Qualified
Health Insurance Plans MUST cover these 10 items without any lifetime or annual
limits on these “Essential Health Benefits.”
There are exceptions to those that have to buy these plans. Those
folks that have a State or Federal plan (Medicare, Medicaid, VA, Tricare, CHIP
etc.,) or are a part of an Employer Group that provides benefits or are
“Grandfathered” or that the insurance is “unaffordable” won’t need to
buy. All the rest of us, unless we are “Exempt” our plan must cover these
benefits to be the correct kind of insurance to avoid paying the tax penalty,
or until our insurance company tells us our current policy we have now (only if
it’s a major medical policy) renews and we must buy a “Qualified Health Plan”
that has the following benefits:
Ambulatory
patient services (clinics, doctors office, same-day surgery centers,
etc.)
Emergency
services
Hospitalization
Maternity
and newborn care
Mental
health and substance use disorder services, including behavioral health
treatment
Prescription
drugs (see below)
Rehabilitative
and habilitative services and devices
Laboratory
services
Preventive
and wellness services and chronic disease management
Pediatric
services, including dental and vision care (see below)
The
Dental for
“Pediatrics” means anyone under the age of 19 must have a dental plan to be
compliant with the law. The dental plans have 2 levels. The low
level plan covers 70% of the dental costs, and the high level plan covers 85%
of the costs. The Out of Pocket maximum for the parents for 1 child (or
adult) is $700 or $1,400 for 2 or more kids (or adults.) The pediatric dental has to be
covered on and off of the exchange.
Vision for children under the age of 19 is
covered, 1 visit per year, 1 pair of glasses per year are covered. The
pediatric vision has to be covered on and off of the exchange.
As always, if you have questions, we are here to help. You can call us at (702) 898-0554 or visit us online: http://nevadainsuranceenrollment.com/
Thank you for considering Nevada Insurance Enrollment Marketplace for your health insurance needs.
Sincerely,
Shelly Rogers
Nevada Insurance Enrollment MarketplaceLicensed Agent #560016
Phone: (702) 898-0554
E-mail: Shelly@NevadaInsuranceEnrollment.com
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