Health Is insurance and Essential Benefits

Health care reform has lifted dollar limits on essential benefits. On September 23rd of last year, the dollar limit on the following essential benefits have been lifted:
  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • 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
Keep in mind that this does not mean that you have no dollar limit on all covered services under your policy. Because there was some vagueness in the new law, carriers are altering their plans as they choose to in some areas. It is recommended that you touch base with your agent or carrier to be sure of the services that still have dollar limits on them. When 2014 rolls around, then we should see the elimination of dollar limits on all benefits. Also, because of the lift on dollar limits on essential benefits, it’s believed that this will drive up the price of health insurance.