insurance

2014 brings Obamacare savings and sanctions

Essential benefits
Essential benefits © Syda Productions/Shutterstock.com

Health insurance plans rarely resemble one another in the same way that auto or home insurance policies do. But that's changing, now that plans offered through the new state exchanges must offer the same minimum set of essential benefits.

The new federal health essentials include: hospitalization, surgery, outpatient and emergency care; maternity, newborn and pediatric services; rehabilitative care and equipment for the injured, disabled and those with chronic conditions; mental health and substance abuse treatment; prescription drugs; lab work; and preventive and wellness services.

While some pre-Obamacare "grandfathered" plans may cover these essential benefits, they are not required to do so.

In addition, insurers can no longer place yearly dollar limits on your coverage for these essential benefits, though they can continue to place annual or lifetime spending caps on other health care services.

"This is where the new health care law really steps up to protect people," says Janet Schwartz, assistant professor of marketing at Tulane University. "One, it makes sure that everybody has some level of insurance. And two, it also makes sure that, if you are insured, you're actually able to make claims and not have your claims denied."

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