Qualified health plan defined

[Antares]

b) Essential Health Benefits-
(1) IN GENERAL- Subject to paragraph (2), the Secretary shall define the essential health benefits, except that such benefits shall include at least the following general categories and the items and services covered within the categories:
(A) Ambulatory patient services.
(B) Emergency services.
(C) Hospitalization.
(D) Maternity and newborn care.
(E) Mental health and substance use disorder services, including behavioral health treatment.
(F) Prescription drugs.
(G) Rehabilitative and habilitative services and devices.
(H) Laboratory services.
(I) Preventive and wellness services and chronic disease management.
(J) Pediatric services, including oral and vision care.

(3) RESTRICTION TO INDIVIDUAL MARKET- If a health insurance issuer offers a health plan described in this subsection, the issuer may only offer the plan in the individual market.

Bill Text - 111th Congress (2009-2010) - THOMAS (Library of Congress)


All plans that are offered on the Exchange must include these coverages....

 

[Antares]

Sooooooooooooooooo.......ONLY qualified plans can be sold on the Exchanges.....

 

[hjmick]

Why do I need maternity and newborn care and pediatric services?

 

[Antares]

(1) INDIVIDUAL MARKET- A health insurance issuer shall consider all enrollees in all health plans (other than grandfathered health plans) offered by such issuer in the individual market, including those enrollees who do not enroll in such plans through the Exchange, to be members of a single risk pool.

Why does this exclude grandfathered plans?

 

[hjmick]

Because grandfathered plans are only good if you had it before the law was signed and only if it didn't change, at all, not even a $5.00 increase...

 

[Antares]

Because grandfathered plans are only good if you had it before the law was signed and only if it didn't change, at all, not even a $5.00 increase...

Correct...and the grandfathered plans die next Dec....no matter what.

Only qualified plans can be purchased with subsidies....only qualified plans can be sold on the Exchanges....

 

[percysunshine]

Why do I need maternity and newborn care and pediatric services?

Maybe it was that alcohol fueled Mardi Gras party and the blond waitress...you know, about 8 1/2 months ago.

 

[Antares]

(5) PREMIUMS-
(A) PREMIUMS SUFFICIENT TO COVER COSTS- The Secretary shall establish geographically adjusted premium rates in an amount sufficient to cover expected costs (including claims and administrative costs) using methods in general use by qualified health plans.

The "Secretary"......establishes the rates.....so much for "greedy" insurers.....

 

[Antares]

[MENTION=43872]PMZ[/MENTION]....evidence?

 

[Wry Catcher]

Why do I need maternity and newborn care and pediatric services?

Consider those who do need such coverage and do not receive it. Won't the expectant mother go to the ER when the baby in on the way? Won't they go to the nearest ER if their newborn needs medical attention? Won't they go to the ER if during pregnancy the expectant mother needs medical attention? Won't children without health insurance fail to get proper preventative care and potentially need emergency care at the ER?

Consider the costs of ER treatment and who pays for it. Yeah, you and me.

 

[Quantum Windbag]

Why do I need maternity and newborn care and pediatric services?

What if you get pregnant?

 

[asterism]

Why do I need maternity and newborn care and pediatric services?

Consider those who do need such coverage and do not receive it. Won't the expectant mother go to the ER when the baby in on the way? Won't they go to the nearest ER if their newborn needs medical attention? Won't they go to the ER if during pregnancy the expectant mother needs medical attention? Won't children without health insurance fail to get proper preventative care and potentially need emergency care at the ER?

Consider the costs of ER treatment and who pays for it. Yeah, you and me.

So everyone should be rated and pay for services they will never use on the possibility that some will break the law and not buy subsidized insurance for themselves?

That's bullshit.

 

[westwall]

Why do I need maternity and newborn care and pediatric services?

What if you get pregnant?

Ummmmm, I'm 69 and male....so it's NOT BLOODY LIKELY MATE!

 

[boedicca]

Why do I need maternity and newborn care and pediatric services?

Consider those who do need such coverage and do not receive it. Won't the expectant mother go to the ER when the baby in on the way? Won't they go to the nearest ER if their newborn needs medical attention? Won't they go to the ER if during pregnancy the expectant mother needs medical attention? Won't children without health insurance fail to get proper preventative care and potentially need emergency care at the ER?

Consider the costs of ER treatment and who pays for it. Yeah, you and me.

Straw.Man.Bullshit


Having ObamaCare doesn't mean there are OBGYNs who are willing to treat such expectant mothers.

 

[MeBelle]

Why do I need maternity and newborn care and pediatric services?

Consider those who do need such coverage and do not receive it. Won't the expectant mother go to the ER when the baby in on the way? Won't they go to the nearest ER if their newborn needs medical attention? Won't they go to the ER if during pregnancy the expectant mother needs medical attention? Won't children without health insurance fail to get proper preventative care and potentially need emergency care at the ER?

Consider the costs of ER treatment and who pays for it. Yeah, you and me.

Please tell that to HHS Sebelius.

Eleven million illegal immigrants get their health care through the ER.

 

[Quantum Windbag]

Why do I need maternity and newborn care and pediatric services?

What if you get pregnant?

Ummmmm, I'm 69 and male....so it's NOT BLOODY LIKELY MATE!

I have been making that argument for 5 years, everyone keeps pointing out how lucky I am to have it now.

 

[Antares]

Golly...PMZ and ifitz are too afraid to ventureintoa real thread?

 

[OnePercenter]

Why do I need maternity and newborn care and pediatric services?

The big question is why you didn't list '(E) Mental health and substance use disorder services, including behavioral health treatment', but I'm sure you complain about school bond issues even though you haven't paid for the free education you received.

 

[Antares]

Why is the Left so afraid of this thread?