General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe ten essential health benefits where Trumpcare saves money.
Last edited Sat May 6, 2017, 07:39 PM - Edit history (1)
===========
Essential health benefits
The ACA sets forth the following ten categories of essential health benefits,[5][6] at Section 1302(b)(1) of the Affordable Care Act, codified at 42 U.S.C. § 18022(b):[7]
Ambulatory patient services. [outpatient care]
Emergency services.
Hospitalization. [inpatient care]
Maternity and newborn care
Mental health and substance use disorder services, including behavioral health treatment.
Prescription drugs.
Rehabilitative and habilitative services and devices.
Laboratory services
Preventive and wellness services and chronic disease management;
Pediatric services, including oral and vision care.
The essential health benefits are a minimum standard: "Qualified health plans are not barred from offering additional benefits, and states may require that qualified health plans sold in state health insurance exchanges also cover state-mandated benefits."[8]
https://en.wikipedia.org/wiki/Essential_health_benefits
frazzled
(18,402 posts)There will be a lot of policies out there that will not cover a lot of stuff, and it could cost you your life.
Does your doctor order a PET scan for a heart, brain, or cancer situation? "A PET scan typically costs an average of about $4,900 for a PET scan of the whole body to $6,700 for the brain and $6,800 for the heart." (And I don't think that cost counts in the charges for a specialized technician to read and report out on the findings back to your doctor.) Not a covered laboratory service under your wonderful new plan? During my husband's chemo course, he had to have three or four of them (plus many CT-scans, laboratory tests, surgical biopsies, etc. etc.) Will the new and improved plans offered under TrumpDon'tCare cover all these procedures? I'm doubting it. Buh-bye.
Nevermypresident
(781 posts)These "essential benefits" are basically what most of us consider "Insurance"!!
When the premeditating murderers tried to pass it the 1st time, I discussed this issue with family members and friends. They thought I was crazy and had to be wrong.
Isn't it interesting that the powerful healthcare lobbies (hospitals, physicians, skilled nursing, rehab, etc.) haven't prevailed in this legislation? But, boy oh boy, Pharma and Insurance are going to continue to make out like bandits.
Thank you for starting this thread.
kentuck
(111,110 posts)You can probably get insurance pretty cheap.
justgamma
(3,667 posts)Just because he mentioned buying medicine overseas, doesn't make it true. The Repukes fought that tooth and nail when Dems wanted it.
kentuck
(111,110 posts)...the ten essential benefits that the ACA requires as a minimum.