The ACA (Affordable Care Act aka. Obamacare) requires all new health plans to provide 10 “Essential Health Benefits.” These benefits are:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (such as surgery)
- Maternity and newborn care (care before and after your baby is born)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services
However, the new national health care plan does not cover dental or vision plans for adults. They do provide limited access to traditional dental & vision plans, but not the best plans – Visit www.pikespeakstrategicgroup.com for the very best discount dental plans and discount health plans.
Neither of the four ACA plans cover all medical costs. In addition, insurance costs will probably rise next year between 12-15 percent, and similar cost increases are seen in the near future.
Each ACA plan is structured so members pay for services on the front end and their share on the back end of each usage. To keep cost down, most members have accepted front end – high deductibles, most up to $5000.00.
This means your insurance plan will not pay until you have paid the deductible – out of your own pocket – for each medical use, on an annual basis.
These caps or deductibles apply for each calendar year and each usage. For instance, if a person gets sick this year and visits the hospital one must pay that $5000.00 deductible. Should there be another medical issue beginning in January 2015, that $5000.00 deductible must be paid again.
Over and above the information provided just stated each member is still totally responsible for their back end portion of the final bill. As an example, the ACA Silver Plan or 70/30 version means you must are responsible for the initial $5000.00 deductible and the entire 30% portion of the final medical bill.
The ACA does not cover any portion of a senior citizens denture needs – AmeriPlan via the PPSG offers discounts up to 65%. The ACA nor most traditional insurances provide any coverage for adult braces – AmeriPlan via the PPSG does.
The most significant statement(s) we can provide regarding the outstanding benefits of being an AmeriPlan member are:
We can definitely reduce your “out of pocket” expenses on a continuous basis for your entire household
- We will help your entire household, not just family members
- We absolutely promise to help each member for either $19.95, $29.95 or $49.95, depending upon what plan is taken
AmeriPlan discount health and dental plans are designed to save you money while providing the health and dental care you and your family needs. Get started now and you’ll be amazed at the level of medical and dental services and the low cost.