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10 Benefits Health Insurance Marketplace Plans Must Cover in 2020

An African-American woman measuring the blood pressure of a middle-age Caucasian woman to portray the benefits covered by marketplace health care.

Open enrollment season is here, and if you need to buy or renew a policy, the process can seem complicated and intimidating because there are so many options. The best thing you can do to avoid confusion is gathering all the information you’ll need to make the right choice and, overall, know your health insurance rights. Also, you must familiarize yourself with the health insurance marketplace, a service that allows people to choose affordable health insurance.

What You Should Know About Marketplace Insurance Plans

The Affordable Care Act (also known as ACA or Obamacare) guarantees quality care that covers all possible necessities for everyone getting coverage through a healthcare marketplace. Said necessities are divided into ten essential health benefits that every health plan should include:

  1. Ambulatory patient services (outpatient care without hospital admission).
  2. Emergency services.
  3. Hospitalization (surgeries and overnight stays).
  4. Pregnancy, maternity, and newborn care (pre and postnatal).
  5. Mental health and substance use disorder services.
  6. Prescription drugs.
  7. Rehabilitation and habilitation services and devices (for those patients that need to acquire, maintain or improve necessary skills for quality of life).
  8. Laboratory services.
  9. Preventive and wellness services and chronic disease management.
  10. Pediatric services, including oral and vision care. All plans purchased through the marketplace include dental insurance for children.

Keep in mind that plans must also include birth control and breastfeeding coverage.

How Can I Get Marketplace Insurance?

California’s state-based insurance marketplace is Covered CA, where you can apply and enroll for health insurance and see if you qualify for any discounts or the state’s Medi-Cal program. The Department of Health Care Services sponsors the service. The best way to ensure you get the best possible coverage is by talking to an insurance professional that can guide you through the process.

Covered California enrollment is available only during open and special enrollment periods. For marketplace insurance 2019, remember that enrollment in California began on October 15 and ends on January 15, 2020.

What if I Have a Pre-Existing Condition?

Under ACA, no one with a pre-existing condition can be denied coverage. So, if you look for a plan on a health marketplace, insurers have to provide coverage and can’t increase your premiums, even if you have chronic or severe conditions. This rule applies no matter the plan category (the “metal levels”) or type (HMO or PPO, for example).

Also, insurance providers can’t put a cap on how many benefits you receive or increase how much money you pay out of pocket. So read the terms carefully before choosing your insurance plan and make sure you fully understand your rights.

How Can I Get a Health Insurance Quote in California? 

Navigating the health insurance maze can be difficult and get very expensive if you don’t know your way through it. Because of this, it is always best to seek out the help of an insurance professional that can help you understand the process and make the right choice for you. Freeway’s licensed agents are experts at finding the best coverage for you without the hassle. We can also help you find out if you qualify for financial help or Medi-Cal.

Don’t let open enrollment season pass you by; Freeway Insurance can help you explore, compare, and apply for health insurance marketplace plans. Luckily, there are several options to request a free health insurance quote, so choose the one that’s most convenient for you and discover how much you can save today. You can quickly start the quote process online, give us a call at 877-583-1475 to talk to an agent, or visit one of our locations near you.

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