Navigator
Resource Guide
On Private Health Insurance Coverage & The Health Insurance Marketplace
FAQs tagged with “Essential Health Benefits”
- I got this notice that says I can renew my insurance plan, which I've had since 2013. Should I renew? What are the benefits and disadvantages of doing that?
- I heard Marketplace plans have to cover certain health benefits referred to as essential. What are essential health benefits?
- I thought a colonoscopy screening was a free preventive service. When I went in for my screening, an abnormal growth or polyp was found and removed. I just received a bill for the removal of the growth. What can I do?
- I thought my employer plan couldn’t have any annual or lifetime limits on benefits but I heard that there are limits in our plan. Is that allowed?
- I thought prescription drugs were supposed to be covered in all plans, but my plan doesn’t include them. Is that allowed?
- I thought that contraceptives were now covered, but I heard on the news that some employers don’t have to cover them. Is that true?
- I thought there was an annual cap on my out-of-pocket costs, but I’m getting billed for something that puts me well above the limit. How can that be?
- I went for a preventive screening colonoscopy and received a bill for the anesthesia used during my procedure as well as for the pathology exam to examine the polyp that the doctor found. Is this allowed?
- I went to my doctor’s office for a flu shot, but was charged for an office visit. I thought preventive services were covered without co-pays. How can that be?
- Is dental coverage an essential health benefit?
- My employer plan has an annual limit on my benefits. Is that still allowed?
- What health plans are offered through the Marketplace?
- Will covered benefits under all Marketplace plans be the same? How can I compare?