what are the 10 minimum essential health benefits

A breakdown of all 10 essential health benefits

1. Outpatient care. Technically called ambulatory patient services, this is any care you receive without going to a hospital.
2. Prescription drugs. All individual and small-group health plans cover at least one drug in each category and class listed in the United States Pharmacopeia (USP).
3. Pediatric care. ...
4. Preventive care. ...
5. Laboratory services. ...

More items...

Full Answer

Which benefits do you consider essential?

What can you suggest to help your company manage this rising cost?

1. Which benefits do you consider essential — that is, which benefits would require before accepting any job offer? Why are these benefits important to you?
2. Imagine that you are the human resource manager of a small architectural firm. ...
3. Why is it important to communicate information about employee benefits? ...

What are the 10 essential health benefits?

• Outpatient care (ambulatory services)
• Prescription drugs
• Pediatric care (including dental and vision coverage)
• Preventive care
• Laboratory services
• Emergency services
• Hospitalizations
• Mental health coverage
• Rehabilitative and habilitative services
• Pregnancy, maternity, and newborn care

What are prescribed minimum benefits?

• any emergency medical condition;
• a limited set of 271 medical conditions (defined in the Diagnosis Treatment Pairs); and
• 25 chronic conditions (defined in the Chronic Disease List).

What are non-essential benefits?

Examples of non-essential benefits might include:

• Chiropractic muscle manipulation
• Diabetes management education
• Orthotics
• Wigs
• Hearing aids
• Travel, meals, and lodging in the event of a transplant operation
• Acupuncture

What does minimum essential coverage include?

Minimum essential coverage, also called qualifying health coverage, is any health plan that meets Affordable Care Act (ACA) requirements for having health coverage. Qualifying plans include marketplace insurance, job-based health plans, Medicare, Medicaid and the Children's Health Insurance Program (CHIP).

What is considered an essential health benefit?

These include doctors' services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. Some plans cover more services. Plans must offer dental coverage for children. Dental benefits for adults are optional.

What term is used to describe the 10 statutory benefits considered to be essential to be provided by a qualified health plan?

Federal "Essential Health Benefits (EHB) The Patient Protection and Affordable Care Act (ACA) provides for "essential health benefits," defined as health treatment and services benefits in sections 1302(a) and (b).

What is an example of an essential benefit?

emergency services. hospitalization. maternity and newborn care. mental health and substance abuse disorder services, including behavioral health treatment.

What is not considered an essential health benefit?

Examples of non-essential benefits might include: Chiropractic muscle manipulation. Diabetes management education. Orthotics.

Which of the following is not considered an essential health benefit?

Which of the following is NOT an essential health benefit found in qualified health plans? Qualified health plans (QHPs) must offer essential health benefits such as emergency, rehabilitative and pediatric services. Dental services are not included in the list of essential health benefits.

Which of the following requires health insurance companies to cover 10 essential health benefits?

The Affordable Care Act, also known as the ACA or Obamacare, allows you to buy individual and small group (small business) health insurance plans through an ACA marketplace (also called an exchange). All qualified health insurance plans sold through the Obamacare marketplace must cover the 10 essential health benefits.

What is the difference between minimum essential coverage and minimum value?

Minimum Essential Coverage (MEC) and Minimum Value (MV): Minimum Essential Coverage is a lower threshold than Minimum Value (MV). MV is the 60% Actuarial Value and is met when a plan pays on average at least 60% of the actuarial value of allowed benefits under the plan.

Which are the essential health services which should be included in the annual plan?

Essential health benefits ensure that health plans cover care that patients needAmbulatory patient services (outpatient services)Emergency services.Hospitalization.Maternity and newborn care.Mental health and substance use disorder services, including behavioral health treatment.Prescription drugs.More items...

Which of the following are essential health benefits required by all qualified health plans quizlet?

Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; ...

Which of these are essential health benefits quizlet?

Which of these are essential health benefits? All are essential health benefits (Prescription drugs, emergency services, and maternity and newborn care.)

What is essential in the essential health benefits and will occupational therapy benefit?

But essential benefits must also include rehabilitative and habilitative care, such as occupational therapy and medical devices, that address physical, cognitive, and behavioral concerns to maintain, attain, and restore as much function as possible.