It is an irony but true that Americans always live with the fear of going bankrupt if unluckily they have to obtain medical care. Right from a doctor’s visit to the prescription drugs, or screenings and lab tests, the cost of these medical services can cost a fortune in this country. However, people having health insurance plans can relax a little bit but people who do not have health insurance will find difficulty in paying up the incredibly high cost of emergency care or surgery or even a visit to the hospital unless they are wealthy and rich. Thanks to the Affordable Care Act, a large number of Americans were able to buy health insurance plans to stay protected. Moreover, it is the health insurance marketplace of the country that offers several high-quality health plans. By shopping through the marketplaces, people can afford expensive medical facilities and obtain the right treatment for their healthcare problems.
People Who Are Eligible to Receive Health Insurance Benefits from the Marketplace
Following Individuals are Eligible to Obtain Health Insurance Benefits:
- U.S. citizens and national
- Legal immigrants having legal immigration documents
Individuals eligible to Receive Health Insurance Benefits from the Marketplace end due to the Following:
- Not having legal immigration document
- Individuals who are incarcerated
is always better for individuals who are eligible to buy a health insurance plan that suits them from the marketplace.
Benefits offered by Health Insurance Marketplace
Individuals and their Families Receive the following Health Insurance Benefits:
- Health conditions that generate the need for emergency facilities
- Individuals who require an in-patient admission into a hospital or nursing home
- Health conditions that do not require hospitalization, yet medical assistance from a physician is required. Even as outpatients, health plan covers the insured if they have visited the doctors who are in-network with their chosen plan.
- Earlier mental problems like schizophrenia or paranoia were no covered by any health plan but after the implementation of the ACA, mental illness, substance abuse, or even behavioral therapy is covered. In case, if the insured or someone in their family needs psychiatric counseling or hospitalization, then the marketplace will assist them.
- If individuals are on some prescription drugs, then they will be surprised to know that drugs can be affordable outside a health plan. However, for some prescribed medicines, individuals might need the assistance of the exchange for sharing the medicines’ costs.
- After the implementation of the ACA, women get coverage for the cervical cancer detection test and breast cancer detection test, as proper screening is required to prevent it from getting fatal. Women need to get themselves checked for these two major types of cancer.
- The health insurance marketplace assists individuals who require physiotherapy, speech therapy, psychological counseling, etc. These conditions do not require hospitalization but people are required to undergo a prolonged period of therapies for the treatment.
- The medical costs of pregnancy, childbirth and post-delivery care are shared by the health insurance provider.
- Different types of lab tests like blood, x-rays, ECG, EEG, etc. are covered by health plans.
- Healthcare plans do provide subsidies to senior citizens who require geriatric care.
- Huge subsidies are provided by ACA through Child Health Insurance Plan (CHIP) for pediatric health care like dental and vision care.
- Children till the age of 26 years are allowed to stay on their parents’ plans.
- Preventive services like vaccination for diseases like polio, dengue, etc. are covered under the health insurance plans.
- Individuals who fall under 133% to 400% of the Federal Poverty Level (FPL) are eligible for Medicaid and Medicare. However, it mostly depends upon the income of the family of 4 people.
Health Insurance Marketplace Coverage Benefits
The benefits of the health plans available at the marketplace include coverage for a doctor visit, pre-existing conditions, surgery, laboratory tests, hospitalizations, and emergency care.
Some of the other benefits offered by the health insurance marketplace are:
- The psychology and psychiatry problems were not covered under health plans but now services related to substance abuse and mental health have been included in the marketplace plans, along with behavioral therapies that require counselling and psychotherapy.
- Women are provided with all the healthcare facilities during the maternity even if their coverage has not yet been effective. Besides, some plans help them receive benefits during breastfeeding.
- Women also enjoy special benefits in preventive care services like examinations and child prevention medicines.
- Prescription medicines
Now a lot of people in the U.S. can afford healthcare, all due to the health insurance marketplace. Earlier people who could not afford healthcare costs just have Medicare and Medicaid to their rescue but since 2010 after the implementation of the ACA, a large number of people in the U.S. can afford healthcare services.