Health Benefits Under The Affordable Care Act

In order for an insurance plan to be compliant with Health Care Reform, it must cover the following ten minimum essential health benefits, as mandated by the Affordable Care Act:

  1. Ambulatory patient services  (outpatient services, labs, and testing)
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative services and devices
  8. Laboratory services
  9. Preventive, wellness services and chronic disease management
  10. Pediatric services, including oral and vision care

If you purchase health insurance through the Federal Marketplace, or one of the state-run health insurance marketplaces established under The Affordable Care Act, you can be sure that your plan will include some degree of coverage for all of the health insurance benefits list above.

All individual plans offered through WNC Health Insurance / The Asheville Blue Cross and Blue Shield of North Carolina® Store are Affordable Care Act compliant and provide coverage for the required ten minimum essential health benefits.  Our personal reform advisors will help you understand the types of coverage offered by each plan, and will assist you in finding a plan with the lowest premium and the most health insurance benefits for your family.

If you live in North Carolina and do not purchase a health insurance plan either directly through the Federal Marketplace, or from one of the personal reform advisors at WNC Health Insurance / The Asheville Blue Cross and Blue Shield of North Carolina® Store, make sure that the plan you select offers coverage for all ten of the health benefits listed above. Temporary health insurance plans that do not cover these required benefits are considered non-compliant with the Healthcare Law.

Temporary health insurance plans, while offering lower premiums, do not count towards meeting the individual federal mandate to carry health insurance under the Affordable Care Act. If you have only temporary coverage, you will be treated the same under the Healthcare Law as those who are without health benefits, and you and your family will be required to make an individual shared responsibility payment (i.e. pay a penalty for each family member without compliant insurance) when filing your taxes.