Menu
Indianapolis Delays Essential Health Benefits
The Essential health benefits must include items and services within the following 10 categories: Ambulance, Emergency Services, Hospitalization, Maternity, New Born Car, Mental health and substance abuse, behavioral health, Prescriptions, Rehabilitative, Laboratory, Preventive, Disease management, Pediatric with oral and vision.
This is a very big part to the Affordable Care Act. These coverage’s will have a huge impact on both cost and quality of care. At first, the federal government was to establish the benefits. They decided to pass the responsibility down to the state level.
The essential benefits is one of the main aspects that will impact health insurance premiums. If a gastric bypass surgery was to consider an essential benefit. Every Hoosier that needed this surgery would have it covered. Does not matter if you are on a private insurance plan, Medicaid, or Medicare it would have to be covered. Having this one benefit covered could increase the premium for everyone by 1%. 1% does not sound that bad! Now think about more than a hundred different procedures or services that have to be covered. Now we are talking about 100% increase in premium cost! This is the impact the essential benefit will have on every Hoosier and US citizen.
Indianapolis Department of Insurance is delaying the establishment of the essential benefits. They are listing the lack of clarity from the federal government as the reason why. They also list 16 questions that the federal government has not answered.
The questions range from clear deadline for establishing the benefits to premium tax credits for individual dental plans. To most Hoosiers this is boring insurance law but this is so very important to every one of us. This will impact cost and care to all of us.
To have 16 big questions unanswered at this time is very concerning.
