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What does Marketplace insurance cover?


The Affordable Care Act (ACA) was signed into law on March 23, 2010. It is estimated that there are 47 million Americans that lack health care coverage and who could benefit from the health coverage’s that the ACA offers. American got the opportunity to enroll for insurance coverage through the Health Insurance Marketplace on October 1st.  The enrollee’s policies will go into effect on January 1, 2014.


The purpose of this article is to point out the benefits that Marketplace insurance covers. Some of the changes have already gone into effect.  For instance:


  -  Parents can now include their adult children on their insurance plans up to 26 years of age.

  -  If an individual gets sick, the insurance company cannot drop them from the plan or limit the amount of insurance coverage that they receive.

  -  In most cases pregnancy examinations will be free.

  -  Insurance companies that spend less than 80% of premiums on providing medical services have to issue refund checks to policy-holders if they spend it on advertising or executive salaries.


Under the ACA Marketplace insurance policies must now provide coverage for:


  -  Emergency services
  -  Laboratory services
  -  Maternity care
  -  Pediatric care
  -  Vision and dental care for children
  -  Preventative care
  -  Prescription drugs
  -  Outpatient or ambulatory care
  -  Hospitalizations
  -  Mental health and substance abuse treatment


In addition under the ACA marketplace insurance policies:


  -  Individuals can no longer be denied coverage because of pre-existing conditions.

Insured patients can no longer be dropped from coverage because they have exceeded annual or lifetime limits.


  -  Insured patients can no longer be dropped from coverage for making a mistake on their application. 

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