What is not included in the Affordable Care Act?

Asked by: Mr. Bertha Schulist IV  |  Last update: November 3, 2023
Score: 4.9/5 (50 votes)

Long-term care: You will need to pay for long-term care if you become disabled or need to move to a nursing home. It's not an essential health benefit under the Affordable Care Act and is not covered by Medicare or most private health plans. Abortion: Abortion is not one of the essential health benefits.

Which is not an essential benefit covered under the Affordable Care Act?

Essential health benefits do not include certain services, such as: Dental coverage for adults, though some plans may offer this as a benefit. Vision coverage for adults, though some plans may offer this as a benefit. Long-term nursing-home care.

What does the Affordable Care Act include?

A set of 10 categories of services health insurance plans must cover under the Affordable Care Act. 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.

Is medical under the Affordable Care Act?

Medi-Cal assistance: Starting in 2014, California expanded Medicaid (also known as Medi-Cal) to cover people under age 65, including people with disabilities or with low income. The coverage is part of the Affordable Care Act and is free for those who qualify.

How did the ACA fail to provide access to healthcare for all individuals?

It largely failed. Health insurance markets are only afloat because of massive federal subsidies and premiums and out-of-pocket obligations significantly increased for families. While the ACA has led to about 13 million more people with Medicaid, many more have been harmed.

Obamacare Explained: Understanding the Affordable Care Act

41 related questions found

Is Affordable Care Act based on income?

Under the Affordable Care Act, eligibility for subsidized health insurance is calculated using a household's Modified Adjusted Gross Income (MAGI). You are expected to pay a premium contribution limit (a percentage of your annual income) for healthcare coverage.

What 3 things did the Affordable Care Act do?

The law has 3 primary goals:
  • Make affordable health insurance available to more people. ...
  • Expand the Medicaid program to cover all adults with income below 138% of the FPL. ...
  • Support innovative medical care delivery methods designed to lower the costs of health care generally.

What are the 10 essential benefits of the Affordable Care Act?

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

What are 3 benefits of the Affordable Care Act?

Affordable Care Act (ACA) basics

Among other things, the ACA made it easier for many people to get coverage, removed annual and lifetime limits on essential health benefits and put in place requirements that individuals have medical coverage or pay a tax penalty.

What are the two main parts of the Affordable Care Act?

The law has 2 parts: the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act.

How many categories are there in the Affordable Care Act?

Plans in the Marketplace are presented in 4 health plan categories: Bronze, Silver, Gold, and Platinum. (“Catastrophic” plans are also available to some people.) Health plan categories are based on how you and your plan split the costs of your health care. They have nothing to do with quality of care.

What happens to the ACA subsidy when one person goes on Medicare?

You are not required to cancel your exchange plan when you enroll in Medicare, but if you're getting premium subsidies, they'll end when you become eligible for premium-free Medicare (with some flexibility in terms of the exact date for this, as described below).

Does the Affordable Care Act require everyone to have insurance?

As of Jan. 1, 2019, there is no mandate for health insurance at the federal level. Before 2019, under the ACA, also called Obamacare, U.S. adults who were not otherwise eligible for an exemption were required to have health insurance coverage for themselves and their families.

What are the minimum essential coverage requirements of the Affordable Care Act?

Minimum essential coverage is an insurance plan that meets the ACA standards for a qualified health plan. A qualified health plan must be certified by the federal Health Insurance Marketplace, provide 10 essential health benefits required by the ACA and follow federal limits on fees like deductibles and copays.

What is not covered under health insurance review under essential health benefits?

Excluded Benefits

Pursuant to 45 CFR 156.115, the following benefits are excluded from EHB even though an EHB-benchmark plan may cover them: routine non-pediatric dental services, routine non-pediatric eye exam services, long-term/custodial nursing home care benefits, and/or non-medically necessary orthodontia.

What types of plans do and don t qualify as minimum essential coverage?

What plans are not considered minimum essential coverage? Policies that are not major medical coverage and not regulated by the ACA do not count as minimum essential coverage. This includes discount plans, limited-benefit plans, critical illness insurance, accident supplements, and dental/vision plans.

Which of the following is a benefit of the Affordable Care Act quizlet?

Increases benefits and lower costs for consumers, bolster our health care and public health workforce and infrastructure, foster innovation and quality in our system. Covers preventative care at no cost to you, protects your choice of doctors, removes insurance company barriers to emergency services.

What are three benefits of the Affordable Care Act quizlet?

Match
  • extending insurance coverage to the uninsured/underinsured.
  • decreasing costs by improving efficiency.
  • expanding prevention and wellness programs (PH measures)
  • protecting against undue financial burdens on individuals as a result of healthcare expenditures.
  • improving patient safety and quality of care.

Which of the following was a major goal of the Affordable Care Act?

Those are affordability, medical care that is innovative, and the expansion of Medicaid. The main goal of the ACA was to ensure that every American could afford a health insurance plan.

Why was the Affordable Care Act of 2010 controversial?

One early controversy concerned whether individuals would lose their current health plans when the new law took effect. Initially, some insured people were taken by surprise when their insurers canceled policies that did not qualify as minimum essential coverage (MEC) under the ACA.

What were the two main goals of the Affordable Care Act ACA with respect to health insurance?

The Patient Protection and Affordable Care Act (ACA) has two main goals: (1) to make health care coverage more available, affordable, and acceptable and (2) to slow the growth of health care costs in the U.S.

Does Affordable Care Act count Social Security as income?

Does Social Security Income Count As Income For Health Insurance Subsidies? Non-taxable Social Security benefits are counted as income for the Affordable Care Act and affect tax credits. This includes disability payments (SSDI), but does not include Supplemental Security Income.

Who gets Affordable Care Act?

Who Is Eligible for Obamacare (Affordable Care Act) Coverage? Key takeaways: The Affordable Care Act (ACA), also known as Obamacare, gives most uninsured people in the U.S. access to health insurance as long as they are U.S. citizens who live in the country, are not incarcerated, and are not covered by Medicare.

What is the ACA income limit for 2023?

In 2023, you'll typically be eligible for ACA subsidies if you earn between $13,590 and $54,360 as an individual, or between $27,750 and $111,000 for a family of four. For most people, health insurance subsidies are available if your income is between 100% and 400% of the federal poverty level (FPL).