5 things most Obamacare plans won’t cover

Fact-checked with HomeInsurance.com

3 min read

Nose around in your state’s Obamacare marketplace, or online exchange, and you may have a hard time finding a health plan that will cover acupuncture, surgery for obesity or fertility services.

One way the Affordable Care Act aims to cover more Americans is by offering health insurance at prices discounted through tax credits. These subsidized plans, sold in the exchanges, must provide 10 “essential benefits,” including emergency care, hospitalization and prescription drugs. But other services may be excluded.

The administration has had to find a balance between expanding coverage and controlling costs, explains Linda Blumberg, a senior fellow at the Urban Institute’s Health Policy Center in Washington, D.C.

“It’s a real delicate process to try to figure out how much is enough without going so far that you make the whole package unaffordable either at the federal level or for households,” Blumberg says.

The administration left it to the states to decide what to include in a standard marketplace insurance plan, beyond the essentials, and some things were left out of the mix, she says.

Here are five health care services that Obamacare plans may not cover.