The essential health benefits will be based on the largest health plan in the small employer market -- Regence's Innova plan and must include all current state mandated benefits.
Specific coverages and any gaps that need to be filled will be determined through the rule making process started earlier this month, but all plans must include the following categories:
- ambulatory patient services
- emergency services
- hospitalization
- maternity and newborn care
- mental health and substance abuse disorder services - including behavioral health treatment
- prescription drugs
- rehabilitative and habilitative services and devices
- laboratory services
- preventive and wellness services
- chronic disease management
- pediatric services, including oral and vision care
No comments:
Post a Comment