Health Insurance Benefits

Updated: 11 March 2024

What Does Health Insurance Benefits Mean?

Health insurance benefits are the medical or healthcare services and medicines that are provided once someone with a health insurance is in need of them. The insurance company can either pay the medical bills or reimburse the policyholder.

Insuranceopedia Explains Health Insurance Benefits

Under the Affordable Care Act in the US, the following are considered essential benefits of a health plan: outpatient care, pregnancy care, maternity care, newborn care, hospital stay, mental health and substance abuse services, prescription drugs, rehabilitative and therapeutic devices and services, laboratory services, pediatric services, and preventive and wellness services (including chronic pain management).

Dental and vision coverage for adults are not considered essential benefits, however.

Americans are required to have a health insurance that meets federal standards and should check if their insurance provides the essential benefits to avoid tax penalty.

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