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The Affordable Care Act specifies ten benefits to be included in all health insurance plans being sold after January 1, 2014. These services are:

  1. Ambulatory Patient Services: Care you receive without being admitted to a hospital, for example a same day surgery at an Outpatient Facility. Chiropractor and Acupuncture services also fall under this category.
  2. Emergency Services: Care for conditions which, if not immediately treated could lead to serious disability or death.
  3. Hospitalization: Care you receive as a patient in a hospital, such as room and board, care from doctors and nurses, and tests and drugs administered during your stay. This also includes Hospice.
  4. Maternity & Newborn Care: Care provided to women during pregnancy and during and after labor; care for newly born children.
  5. Mental health and substance use disorder services, including behavioral health treatment: Care to evaluate, diagnose and treat mental health and substance abuse issues.
  6. Prescription drugs: Drugs prescribed by a doctor to treat an acute illness, like an infection, or an ongoing conditions like high blood pressure. Medications you pick up at a pharmacy or mail order.
  7. Rehabilitative and habilitative services and devices: Services and devices to help people with injuries, disabilities or chronic conditions to gain or recover mental and physical skills. Physical therapy, inpatient rehab at a Skilled Nursing Facility, durable medical equipment and also speech, occupational and medically necessary massage therapy all included in this benefit.
  8. Laboratory Services: Testing blood, X-rays, pathology, imaging/diagnostic which includes MRI’s, CT and PET scans, to help a doctor diagnose a medication condition and the effectiveness of treatment.
  9. Preventive/Wellness Services and Chronic Disease Management: Preventive or wellness services include routine physicals, screening and immunizations. Chronic disease management is an integrated approach to manage an ongoing condition like asthma or diabetes.
  10. Pediatric Services, including Vision and Oral Care (under 19 years of age): This includes one routine eye exam per year, plus a pair lenses or contacts and 1 pair of frames per year. Also dental coverage for preventive/basic/major services.

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