What do Obamacare health care plans cover?
All health plans purchased through the NMHIX, the health insurance marketplace for New Mexico, must include the following benefits. These are known under Obamacare as “essential health benefits”:
- Ambulatory patient services (meaning outpatient care you receive without being admitted to a hospital)
- Emergency services
- Hospitalization (including surgery)
- Maternity and newborn care
- Mental health and substance use disorder services (including counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (for people with injuries, disabilities, or chronic conditions, to strengthen their mental and physical skills)
- Lab services
- Preventive and wellness services and chronic disease management
- Pediatric services (including oral and vision care)
Companies that offer plans through a state exchange will compete on price and quality of service in delivering these benefits.