- States : TX only
Major Medical ACA plans
What Does Major Medical Insurance Cover?
Long-term health insurance plans are required to cover the following healthcare services, often referred to as the 10 essential health benefits:
- Ambulatory patient services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Special Enrollment For Major Medical Insurance Plans
Some circumstances make you eligible for a special enrollment period, a timeframe outside of open enrollment during which you may enroll in a major medical plan either on the public marketplace or from a private provider.
Qualifying events include:
- Getting married or divorced
- Moving to a new state or area where your current health plan isn't available
- Having a child (including giving birth and adopting)
- Losing your job
You only have 60 days from the time the event took place to participate in the special enrollment period.
This is not an offer to enter into an insurance contract. This is only a summary and shall not bind the company or require the company to offer or write any insurance at any particular rate or to any particular group or individual. The information on this page does and will not affect, modify or supersede in any way the policy, certificate of insurance and governing policy documents (together the "Insurance Contract"). The actual rates and benefits are governed by the Insurance Contract and nothing else. Benefits are subject to exclusions and limitations.