Thursday, November 14, 2013

10 Things A Policy Must Do To Conform With ACA ~ Gail Stone



While at the healthcare clinic today I took advantage of the opportunity to meet with the person who has been employed to assist patients with applying for insurance offered through the state market.
I have heard so much screaming about the fact that some people are being notified by their insurance companies that their previously held policies would be cancelled. Well, the president took care of that for you today. Those who held such policies will now be able to hang on to them for one more year. If you think that's a good thing, you are being extremely short sighted. But, he did it. Now it's in the lap of your insurance company when you get sick and are not covered.
Why were such policies at risk of being cancelled? Because they did not meet certain criteria as mandated by the ACA. There are ten things the law says a policy must do in order to be considered a valid policy. It must provide:

1. Ambulatory services
2. Emergency services
3. Hospitalization
4. Mental health and substance use disorder services. including behavioral health treatment
5. Maternity and newborn care
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventative and wellness services and chronic disease management
10. Pediatric services, including dental and vision

If you think that an insurance company will not sell you a policy that is a piece of crap and does not provide the above....you are living in la la land. They are perfectly willing to take your money, and just as willing to watch you struggle if you get sick, or unexpectedly pregnant. (That's right, boys and girls, birth control sometimes fails. Then what?)

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