What does my plan cover?

All plans must cover recommended preventive care at no cost to you, as long as you see an in-network provider. Further, all plans must also provide what are called the essential health benefits. The type and level of the plan you have will determine which providers you can see and how much you will pay for a specific service. Please be sure to check with your health plan for information about a specific service, procedure, or provider.

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Glossary

Full Glossary

Actuarial Value (AV)

The percentage of total average costs for covered benefits that a plan will cover. For example, if a plan has an actuarial value of 70%, on average, you would be responsible for 30% of the costs of all covered benefits. However, you could be responsible for a higher or lower percentage of the total costs of covered services for the year, depending on your actual healthcare needs and the terms of your insurance policy.

Affordable Care Act

The Patient Protection and Affordable Care Act (PPACA) – also known as the Affordable Care Act or ACA, and generally referred to as Obamacare – is the landmark health reform legislation passed by the 111th Congress and signed into law by President Barack Obama in March 2010. The Affordable Care Act’s main focus is on providing more Americans with access to affordable health insurance, improving the quality of healthcare and health insurance, regulating the health insurance industry, and reducing healthcare spending in the US. The law contains hundreds of different provisions that address different aspects of “the healthcare crisis” in the US.

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What does my plan cover?