I know there is a lot of confusion around the 10 essentials in Obamacare and whether it’s really the best health insurance for the money. Let NHS Heroes explain and you will see why many people are not happy about having to have all 10 of the essentials covered in order to avoid the fine (or taxes which is the appropriate term).
I have helped many people who for one reason or another have found Obamacare to be too expensive or choose to opt out for personal reasons. Even though AHA plans may not meet the 10 essentials, they cover anything that might happen and give people peace of mind. And most of the time I have been able to save people lots of money and get them the best health insurance (even if they have to consider paying the fine).
So let’s clear up some of the confusion:
- Ambulatory Patient Services – Outpatient Services
These are doctor’s office visits. Details about the plans’ networks and access to doctors will vary, but the law says the networks’ size must be “sufficient.”
Most of the best health insurance plans already have this feature and most people need this. Costs for visits vary depending on your plan. No problem; we have you covered here.
- Prescription Drugs – RX Benefits
All individual and small-group plans will cover only one drug in every category and class in the U.S. Pharmacopeia, the official publication of approved medications in this country. Drug costs will also be counted toward out-of-pocket caps on medical expenses.
Obamacare only covers one drug in every category. So what if you need a certain prescription and it isn’t covered? You pay out of pocket. Our plans give you discounts on all prescriptions.
- Emergency Care – ER coverage
This covers you if you go to a hospital emergency room with a sudden and serious condition, such as heart attack or stroke. Emergency room visits do not require preauthorization, and you cannot be charged extra for an out-of-network visit.
Once again, this is pretty basic coverage in the best health insurance plans. With our accident policy, YOU get paid… not the hospital or doctors. Simple and easy!
- Mental health services and addiction treatment.
Inpatient and outpatient care provided to evaluate, diagnose and treat a mental health condition or substance abuse disorder. This includes behavioral health treatment, counseling, and psychotherapy.
Many people are questioning why they have to pay for this if they don’t have a history of mental or behavioral issues. I agree – why would they need this?
- Hospitalization – Inpatient Care
This is the major medical part of Obamacare. It covers you as a hospital patient, care from doctors, nurses and other hospital staff, laboratory and other tests, medications you receive during your hospital stay, and room and board. Hospitalization coverage also includes surgeries, transplants and care received in a skilled nursing facility, such as a nursing home that specializes in the care of the elderly.