With the Affordable Care Act (ACA) going into effect January 1, 2014, most of us (that’s right, including me) have more questions than answers about how it will affect us and the type of insurance coverage that will be available.
Implementing (ACA) is a monumental undertaking. And, although it is going into effect in a few short months, questions are going unanswered, while rules and dates continue to change. However, that doesn’t mean you should sit back and wait. Here are some questions that we’ve run across and want to share with you.
Q: I have insurance through my employer, why should I be concerned about healthcare reform?
A: Even if you have coverage through work, the plans are changing and there are areas of care that will no longer be covered. Plus, there is a good chance the cost of the coverage may increase.
Q: Will long-term care be covered under ACA?
A: As in the past, long-term care will not be covered under a major medical plan. According to www.healthcare.gov, long-term care are services that include medical and non-medical care provided to people who are unable to perform basic activities of daily living such as dressing or bathing. These services will not be covered under the Essential Health Benefits, Medicare or Medicaid.
Q: What is covered under the Essential Health Benefits?
A: There are 10 essential health benefits that will be covered. They include:
- Outpatient care—the kind you get without being admitted to a hospital
- Trips to the emergency room
- Treatment in the hospital for inpatient care
- Care before and after your baby is born
- Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
- Your prescription drugs
- Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
- Your lab tests
- Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
- Pediatric services: This includes dental care and vision care for kid
However, none of these address long term care services that may be needed due to a serious illness or accident.
Q: What types of additional coverage should I consider to supplement my basic healthcare?
A: You might want to explore supplemental benefits such as cancer insurance, critical illness insurance, and long-term care insurance. These coverage options can help you and your family deal with the results of an illness or serious accident.