ACA (Obamacare) Disclaimer

Affordable Care Act (ACA): The comprehensive health reform law that is sometimes referred to as “Obamacare”. Under the ACA, individual medical plans are required to cover ten “Essential Health Benefits” to be recognized as a “Qualified Health Plan” and provide “minimum essential coverage” to enrollees(“MEC”). Residents of certain states may not be able to enroll in ACA-compliant health insurance through Find My Health Quote agents. To see all available data on QHP options in your state, go to the Health Insurance Marketplace website at www.HealthCare.gov. Premium tax credits are not guaranteed and are subject to eligibility requirements determined in the Marketplace.

Short Term Medical (STM): STM Insurance does not provide comprehensive medical coverage and is not minimum essential coverage as defined in the Affordable Care Act (also known as “Obamacare”). STM insurance may not cover all Essential Health Benefits. Check your plan carefully before enrolling.Plans are subject to medical underwriting, and generally do not cover preexisting conditions, and may have lifetime and/or annual dollar limits on health benefits.If your coverage expires, or you lose eligibility, you may have to wait until an open enrollment period to get other health insurance coverage.

All plans offered in the Marketplace cover these 10 essential health benefits:

What Marketplace health insurance plans cover

1. Ambulatory patient services (outpatient care you get without being admitted to a hospital)
2. Emergency services
3. Hospitalization (like surgery and overnight stays)
4. Pregnancy, maternity, and newborn care (both before and after birth)
5. Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
6. Prescription drugs
7. Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

Additional benefits

Plans must also include the following benefits:

• Birth control coverage
• Breastfeeding coverage
• Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements. Plans may offer additional benefits, including:
• Dental coverage
• Vision coverage
• Medical management programs (for specific needs like weight management, back pain, and diabetes)
• When comparing plans, you’ll see exactly what each plan offers.

For more Information go to https://www.healthcare.gov/