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

Asked by: Zechariah Steuber  |  Last update: March 24, 2025
Score: 5/5 (45 votes)

Pursuant to 45 CFR 156.115(d), the following benefits are excluded from EHB even though an EHB-benchmark plan may cover them: routine non-pediatric dental services (for plan years beginning on or before January 1, 2026), routine non-pediatric dental services, routine non-pediatric eye exam services, long-term/custodial ...

What is not covered under the Affordable Care Act?

What Benefits Does the Affordable Care Act Not Cover? The Affordable Care Act does leave two forms of insurance for adults out of its provisions — vision insurance and dental coverage. Although both of these services are considered essential benefits for children under the ACA, they are not included for adults.

What are the essential benefits under the Affordable Care Act?

The 10 categories of benefits in an EHB package are: 1) ambulatory patient services, 2) emergency services, 3) hospitalization, 4) maternity and newborn care, 5) mental health and substance use disorder services, 6) prescription drugs, 7) rehabilitative and habilitative services and devices, 8) lab services, 9) ...

What are considered non essential health benefits?

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

What is not covered under a health benefit plan?

Health insurance typically covers most doctor and hospital visits, prescription drugs, wellness care, and medical devices. Most health insurance will not cover elective or cosmetic procedures, beauty treatments, off-label drug use, or brand-new technologies.

ACA 101: A Comprehensive Guide to the Affordable Care Act

41 related questions found

What is not a covered benefit?

Both private and public health insurance plans can deny coverage for a service on the grounds that it is “not a covered benefit.” This type of denial means that, according to your health insurance plan, your member benefits do not include the requested service and you are responsible to pay for the service.

What does the Affordable Care Act cover?

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.

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

Pursuant to 45 CFR 156.115(d), the following benefits are excluded from EHB even though an EHB-benchmark plan may cover them: routine non-pediatric dental services (for plan years beginning on or before January 1, 2026), routine non-pediatric dental services, routine non-pediatric eye exam services, long-term/custodial ...

What are non benefits?

Non-mandatory benefits, often called voluntary or optional benefits, are extra perks that employers choose to give their employees, not because the law requires it, but as an added bonus. These benefits, which can include both financial and non-financial rewards, are available to both part-time and full-time staff.

What is not considered to be minimum essential coverage?

Health Insurance That Does Not Meet MEC Requirements

They include: Stand-alone dental and vision plans. Accident or disability income insurance. Short-term medical or temporary insurance.

Which is known to be a benefit of the Affordable Care Act?

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 pre-existing conditions are not covered?

Is there health insurance for pre-existing conditions? Choosing a health plan is no longer based on the concept of a pre-existing condition. A health insurer cannot deny you coverage or raise rates for plans if you have a medical condition at the time of enrollment.

Which is not one of the 10 essential health services mandated by the Affordable Care Act?

The service that is not one of the ten essential health services mandated by the ACA is Chiropractic care. While some insurance plans may cover chiropractic care, it is not one of the essential health benefits required by the ACA.

What plans are exempt from ACA?

Grandfathered plans are exempted from many changes required under the Affordable Care Act. Group plans or individual policies may lose their grandfathered status if they make certain significant changes that reduce benefits or increase costs to consumers.

How do I know if my insurance is under the Affordable Care Act?

Check for Premium Tax Credits and Cost-Sharing Reductions

If you receive automatic financial help to pay for your coverage, you probably have an Obamacare plan. The ACA lets plan members apply for two types of assistance: premium tax credits and cost-sharing reductions.

Who does not support the Affordable Care Act?

The Patient Protection and Affordable Care Act (ACA) was passed by a Democratic Congress and signed into law by a Democratic president in 2010. Republican congressmen, governors, and Republican candidates have consistently opposed the ACA and have vowed to repeal it.

Which of the following is a non-mandated benefit?

These can include benefits such as paid vacation time, health insurance (medical insurance), contribution to retirement saving plans, childcare payments, long-term disability coverage, education assistance, wellness programs, and productivity incentives. Non-mandatory benefits can be monetary or non-monetary.

What is no benefits?

It means the employer does not offer anything besides a paycheck (money in exchange for your hours).

What are non standard benefits?

Non traditional benefits aren't the same life insurance and pension incentives every business offers. Rather, these benefits include flexible work arrangements, mental health days, and other demands of the modern worker. Including non traditional benefits in a job offer shows candidates your values.

What are the 10 essential health benefits under the Affordable Care Act?

10 Essential Health Benefits Insurance Plans Must Cover Under the Affordable Care Act
  • 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 is one requirement of the Affordable Care Act?

Insurance companies have to spend at least 80% of your premium dollars on actual medical expenses, not overhead and profit.

Which of the following is not a benefit of insurance?

Which of the following is NOT a benefit of insurance? "Losses due to fraud are eliminated" is NOT a benefit of insurance.

Who is eligible for ACA benefits?

All full-time permanent, full-time nonpermanent and ongoing variable-hour, part-time and seasonal employees are eligible for benefits. If an employee is full-time or meets the 30-hour eligibility requirement, he should be offered benefits.

Which is not one of the three primary goals of the Affordable Care Act?

Therefore, the correct answer to which of the following is not a goal of the ACA is increasing the rates for those insured already, as the ACA aims to make healthcare more accessible and affordable, not to increase the rates for those who are already insured.