{"id":4685,"date":"2021-02-16T18:03:28","date_gmt":"2021-02-16T14:03:28","guid":{"rendered":"http:\/\/gccexchange.com\/blog\/?p=4685"},"modified":"2021-02-16T18:08:25","modified_gmt":"2021-02-16T14:08:25","slug":"what-is-covered-under-a-ny-health-insurance-plan","status":"publish","type":"post","link":"https:\/\/gccexchange.com\/blog\/what-is-covered-under-a-ny-health-insurance-plan\/","title":{"rendered":"What is covered under a NY Health Insurance Plan?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">New York is one of the best places to get\nhealth insurance thanks to the NY State of Health. New York has been a health\nreform leader, enacting several consumer-friendly protection regulations to\nkeep New Yorkers safe. The state fully embraced Obamacare\/The Affordable Care\nAct. New York expanded Medicaid, created a health insurance exchange, and even\ndeveloped a Basic Health Plan (BHP) for those who earn too much to qualify for\nMedicaid but still don\u2019t make over 200% of the poverty level. <\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"640\" height=\"301\" data-attachment-id=\"4687\" data-permalink=\"https:\/\/gccexchange.com\/blog\/what-is-covered-under-a-ny-health-insurance-plan\/ny-health-insurance-plan\/\" data-orig-file=\"https:\/\/i0.wp.com\/gccexchange.com\/blog\/wp-content\/uploads\/2021\/02\/NY-Health-Insurance-Plan.jpg?fit=640%2C301&amp;ssl=1\" data-orig-size=\"640,301\" data-comments-opened=\"1\" data-image-title=\"NY Health Insurance Plan\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/gccexchange.com\/blog\/wp-content\/uploads\/2021\/02\/NY-Health-Insurance-Plan.jpg?fit=640%2C301&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/gccexchange.com\/blog\/wp-content\/uploads\/2021\/02\/NY-Health-Insurance-Plan.jpg?resize=640%2C301\" alt=\"NY Health Insurance Plan\" class=\"wp-image-4687\" srcset=\"https:\/\/i0.wp.com\/gccexchange.com\/blog\/wp-content\/uploads\/2021\/02\/NY-Health-Insurance-Plan.jpg?w=640&amp;ssl=1 640w, https:\/\/i0.wp.com\/gccexchange.com\/blog\/wp-content\/uploads\/2021\/02\/NY-Health-Insurance-Plan.jpg?resize=300%2C141&amp;ssl=1 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption>Image Source: Pixabay<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The Affordable Care Act allowed for the\ncreation of Basic Health Plans (BHPs), but only Minnesota and New York\ndeveloped them. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Does Health Insurance Cover?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">While different plans cover different things, the Affordable Care Act changed how health insurance works, so providers must offer coverage for ten essential benefits. Here\u2019s what your health insurance plan will cover, no matter the provider or tier; for more information we recommend to check out the guided articles on <a href=\"https:\/\/www.nyhealthinsurer.com\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">NY Health Insurer<\/a>.<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Ambulatory\nCare <\/strong><\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Ambulatory care covers the outpatient care\nyou receive before you are admitted to the hospital. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Emergency\nServices <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The ACA dictates insurance providers have\nto provide coverage for any emergency care you get, no matter the hospital you\nare treated or the provider you have. Insurance providers can\u2019t require you to\nsee a specific healthcare provider in their network during an emergency. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Hospitalization\n<\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The hospitalization requirement covers\nhospital stays for planned and emergency surgery and overnight stays in the\nhospital. Hospital stays under 24 hours are covered as part of the ambulatory\ncare services. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Prescription\nMedication <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Every health insurance provider is required\nto offer coverage for prescription medications. However, the insurer can\nrequire you to try generic drugs first. These drugs are cheaper than their\nbrand name counterparts and can be just as effective. Your doctor can request\nan appeal to skip generic medication if they believe those medications will be\nineffective or hazardous to your health. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Laboratory\nServices <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">This section covers things such as blood\ntests, CAT scans, MRIs, and other imaging tests. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Pregnancy,\nMaternity, and Newborn Healthcare <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">New York health insurance covers\npre-and-post-birth care. It also covers labor services for women giving birth. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Mental\nHealth Care and Substance Abuse Treatments <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Health insurance providers are required to\noffer behavioral health therapy and behavioral and mental health inpatient\nservices. They must also provide substance abuse treatments. Insurance\nproviders cannot place annual\/lifetime spending limits on the treatment of\nspecific diseases and conditions. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Preventative\nHealth and Wellness<\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Preventative care covers things such as\nvaccinations, boosters, blood pressure, and cholesterol screenings, and\nscreening for STDs. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Rehabilitation\nDevices and Services <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">This covers physical or occupational\ntherapy. It also covers mobility aids and devices. <\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Pediatric\nCare <\/strong><\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Health insurance should cover dental and\nvision care for children. They are not required to provide these services for\nadults, however. You may have the option to choose extra dental and vision\ncoverage as an add-on for your plan. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These are the essential services required\nby any ACA-compliant healthcare plan. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Doesn\u2019t Health Insurance Cover?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The following are things a health insurance\nplan typically won\u2019t cover \u2013 at least not without a premium attached. <\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Travel\nVaccinations <\/strong><\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Health insurance must cover necessary\nvaccinations and boosters, including immunizations and the flub jab. These\nvaccinations are often a significant part of medically necessary treatments for\ninsurers. However, vaccinations required for international travel might not be covered\nunder insurance. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Weight-Loss\nSurgery <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">There are no federal mandates covering weight loss surgery. Healthcare providers are not required to offer bariatric surgery under <a href=\"https:\/\/gccexchange.com\/blog\/category\/health-lifestyle\/\">health<\/a> insurance plans. If you feel that you, or someone on the plan, may need this surgery in the future, you should first discuss it with the health insurance provider. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Cosmetic\nSurgery <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Health insurance plans only cover medical\nprocedures considered medically necessary. This does not include cosmetic\nsurgery or enhancements such as botox or fat reduction surgery. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Dental,\nVision, and Hearing <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Health insurance plans are only required to\noffer dental, vision, and hearing services to young children. Talk to your\nprovider about getting these coverages for adults on the plan. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Keep in mind that different plans can cover different things. Read through the fine print, talk to the provider, and shop around until you find the right insurance program for you. The Affordable Care Act has made it much easier to find an affordable health insurance plan that covers everything you need, but it is always good to do some research of your own to find the best New York health insurance plan. <\/p>\n\n\n\n<script async=\"\" src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\n<ins class=\"adsbygoogle\" style=\"display:block; text-align:center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-0548205572604330\" data-ad-slot=\"1456790708\"><\/ins>\n<script>\n     (adsbygoogle = window.adsbygoogle || []).push({});\n<\/script>\n\n<script async=\"\" src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\n<ins class=\"adsbygoogle\" style=\"display:block\" data-ad-format=\"autorelaxed\" data-ad-client=\"ca-pub-0548205572604330\" data-ad-slot=\"9687113448\"><\/ins>\n<script>\n     (adsbygoogle = window.adsbygoogle || []).push({});\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"<p>New York is one of the best places to get health insurance thanks to the NY State of Health. 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