Exploring Your Health Insurance Coverage

As restrictions begin to ease and Americans are able to resume more areas of their lives, now is a great time to explore your health insurance coverage.

Studies show that many Americans have put their healthcare on hold during the pandemic. Given the stay at home orders and the pause of many elective procedures, this is not surprising. As restrictions begin to ease and Americans are able to resume more areas of their lives, now is a great time to explore your healthcare coverage and utilize it for your benefit. 

The goal of the Affordable Care Act has long been to enhance the standards of American health insurance. Catastrophic health insurance plans have been greatly eliminated and plans are covering aspects of healthcare that traditionally have been left out. 

Whether you have obtained your plan through the Health Insurance Marketplace or you have an employer-sponsored plan, there are ten essential benefits that must be covered. 

While some of these benefits are self-explanatory, there are some services that are not as straightforward. While your premium, deductible, and co-pay may differ depending on your plan all of the following ten essentials will be covered to some extent. 

If you’re well-versed in all of the services that your health insurance covers, you get a gold star! However, if you know enough to use it but not enough to live your best life then hang in there while we break down the essentials!

Mental Health

Mental health is a growing concern for many Americans, we are beginning to embrace the attitude that checking in on your mental and emotional health is just as important as checking up on our physical health. Thankfully, health insurance is expanding to meet demands. 

Ambulatory Patient Services

This is a tricky one…and no, it doesn’t have anything to do with taking a ride in an ambulance. These services actually include all sorts of outpatient procedures, any test, surgery, or procedure that doesn’t require an overnight hospital stay afterwards. 

Prescription Drugs

This benefit is pretty straightforward. All plans must cover prescription drugs, although the out-of-pocket costs will vary depending on the plan. When you are choosing your health insurance plan be sure to take into account whether or not you have regular prescriptions.

Chronic Disease Treatment

Health insurance plans must cover illnesses that are manageable with treatment but will require long-term treatment. Some examples of chronic diseases include diabetes and asthma. 


This is an essential benefit that no one wants to use but everyone is glad to have if they do. Staying in the hospital isn’t fun but it sure is expensive, so be glad that your health insurance will chip in!

Emergency Services

If you find yourself in an ambulance or the emergency room, you will be thankful that all ACA compliant plans must cover emergency services. 

Maternity And Newborn Care

If you are welcoming a little one into the world during this policy period you will be glad that healthcare plans must cover these services. There are so many tests and procedures that are carried out during a pregnancy that having to pay for them completely out-of-pocket would be overwhelming.

This may sound very self-explanatory, but there is a great deal of care involved when it comes to newborns. ACA compliant plans must cover these services which begin in the delivery room and continue beyond when you bring home your bundle of joy. 

Preventative And Wellness Services

Preventative services are crucial to catching medical issues before they can become a threat. The earlier a health issue is discovered, the more effective the treatment will be. Never hesitate to get a preventative procedure like a mammogram, your health insurance is required to share that expense with you or even cover it completely. 

Occupational and Physical Therapy

Injuries can be very frustrating, especially when you aren’t healing as quickly as you would like. Your health insurance will cover physical rehabilitation services. 

Laboratory Services

Laboratory services include many diagnostic tests. Procedures as simple as having your blood drawn and tested, then you have taken part in laboratory services.

When it comes to testing for COVID-19, many health insurance plans will cover this.

There you have it, these are the essential benefits that the ACA requires all compliant plans to cover. If you are an employer then your employees depend on you for ACA compliant health insurance plans, but who can you depend on? ACAwise…an easy solution to complicated ACA reporting requirements!

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