The COVID-19 pandemic has made health insurance a crucial talking point in recent weeks. The average three-day hospital stay can cost around $30,000 if you are not insured, so having access to affordable health care protects your finances if you become ill.
If you have Obamacare, you have hospital coverage. There are ten mandatory benefits included in every Obamacare plan. By exploring what benefits are and are not in your plan, you can better safeguard your health and finances.
What Does Obamacare Cover? 10 Mandatory Benefits
All Obamacare health insurance plans include specific mandatory benefits. Your policy may include extra benefits, in addition to the ones mandated. Mandated benefits include:
- Hospital care, including overnight stays and surgical procedures
- Emergency services, regardless of network
- Ambulatory services
- Services related to pregnancy, maternity, and newborn care
- Certain prescription drug coverages
- Services related to substance use disorder and mental health
- Rehabilitation services and devices
- Laboratory services
- Wellness and preventative services as well as chronic disease management
- Pediatric services, including vision and oral care for children
Your Obamacare health insurance must include these services. You will still need to pay your cost-sharing amounts for the treatments and services that you receive.
Copayments are small amounts that are due at the time of service. Coinsurance is an amount that you must pay towards your medical expenses after you have met your deductible. You will need to meet your annual deductible before your Obamacare begins to pay its share.
Your plan’s out-of-pocket maximum is the maximum amount of cost-sharing you can incur. This amount does not include your monthly premium. You will only pay copayments and coinsurance for the care you receive until you meet this amount.
When selecting a plan, lower deductibles and out-of-pocket amounts include a higher premium. However, if you contract COVID-19 and need significant medical care, you may save money on a higher premium plan.
What Does Health Insurance Not Cover?
Obamacare health insurance benefits differ by policy. Every plan may include different benefits in addition to mandatory benefits. Several medical services are not generally included in health insurance policies. These services are not considered medically necessary and thus do not usually include coverage. Services that your insurance may not cover include:
- Cosmetic services such as plastic surgery and some dermatological services
- Fertility treatments
- Certain prescription drugs
- Experimental services and treatments
You should review your health insurance policy to determine the services that are not covered by your Obamacare. If you qualify for a special enrollment period, you may be able to change your plan should you need to.
The Cost of Not Having Affordable Health Care During COVID-19
Testing for COVID-19 is now free, but treatment usually isn’t. A growing number of health insurance providers have begun to waive cost-sharing fees for coronavirus treatment.
But in most cases, you must pay cost-sharing fees, including copayments, coinsurance, and deductible amounts. However, your out-of-pocket expenses will not exceed your out-of-pocket maximum for your insurance policy.
If the coronavirus has changed your income, you must update your application on the health insurance marketplace. Doing so may help you receive more premium tax credits that can reduce your monthly premium amount. The health insurance marketplace will also notify you if you are eligible for Medicaid or another assistance program.
The cost of not having Obamacare hospital coverage or another form of insurance? Devastating. Some Americans have incurred huge expenses due to COVID-19 and a lack of insurance. It’s simply too costly not to have affordable health insurance right now.
Let an Insurance Agent Help You with Your Obamacare Hospital Coverage
Access to affordable health care is essential, especially during the COVID-19 pandemic. This virus can affect anyone, young or old. That’s why it’s so important to have access to care, should you need it, without having to worry about the cost.
Obamacare hospital coverage will protect you in an emergency. Insurers cannot charge you more for emergency services, even if a hospital is generally out of their network. While you will still be responsible for out-of-pocket costs, these expenses are far more manageable thanks to your Obamacare. Need help with your Obamacare hospital coverage? Fiorella Insurance Agency is one of the largest licensed insurance agencies in Florida, with over 66,000 healthcare customers and rising. Contact us today to review your options. Or you can get started right now by completing the form below.