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Do Obamacare Plans Cover Eye Exams?

Posted Apr 25, 2017
By Jenifer Dorsey

Do Obamacare Plans Cover Eye Exams?

Under the Affordable Care Act (ACA), there are many things all major medical health insurance plans must cover: preventive services, maternity care, emergency services and prescription drugs, to name a few.[1] But what about other healthcare expenses such as adult dental checkups or doctor office visit when your allergies flare up on vacation?

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Are Immunizations Free Under Obamacare?

Posted Apr 24, 2017
By Jenifer Dorsey

Are Immunizations Free Under Obamacare?

 

What Vaccines Are Covered By ACA Health Insurance Plans

Immunization vaccines are considered an important part of preventive healthcare for children and adults.[1] As such, the Affordable Care Act requires private group and individual health insurance plans to include vaccines among covered preventive services—covered preventive services are offered to insured adults and children at no additional cost beyond their monthly plan premium.

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ACA-covered immunization vaccines

The Advisory Committee on Immunization Practices recommended which immunization vaccines for adults and children should be among Obamacare’s covered preventive services.[2] These vaccines include the following and apply to all major medical plans effective on or after Sept. 23, 2010, whether they are purchased in the private market or from a state-based or federally facilitated health insurance exchange:

Adults[3]

  • Diphtheria
  • Hepatitis A
  • Hepatitis B
  • Herpes zoster
  • Human papillomavirus (HPV)
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Mumps
  • Pertussis (whooping cough)
  • Pneumococcal
  • Rubella
  • Tetanus
  • Varicella (chickenpox)

2016 recommended immunizations for adults, by age (ages 19 and older)

Children[4]

  • Diphtheria, tetanus, pertussis (whooping cough)
  • Haemophilus influenzae type B
  • Hepatitis A
  • Hepatitis B
  • Human papillomavirus (PVU)
  • Inactivated poliovirus
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Pneumococcal
  • Rotavirus
  • Varicella (chickenpox)

2016 childhood immunization schedule (birth through 6 years old)

2016 adolescent immunization schedule (7 through 18 years old)

Immunizations covered by Medicare, Medicaid, CHIP

If you and your family members are covered by Medicare, Medicaid, CHIP or other health insurance plans that may or may not qualify as minimum essential coverage under Obamacare, check with your plan to determine immunization benefits.

A note on ACA-covered immunization vaccines schedules, doctor recommendations

Vaccine doses, the recommended age at which they are received and the populations that should receive them may vary. Your healthcare provider will suggest an immunization schedule appropriate for you.

Even with Obamacare’s essential health benefits and covered preventive services, health insurance benefits differ by plan. Always check with your health insurance plan to confirm your current benefits for immunizations and other healthcare. 

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Originally posted September 2, 2015. Last reviewed and updated August 12, 2016.



[1] U.S. Department of Health & Human Services. “The Affordable Care Act and Immunization.” Last updated Jan. 20, 2012. http://www.hhs.gov/healthcare/facts/factsheets/2010/09/The-Affordable-Care-Act-and-Immunization.html

[2] Ibid.

[3] HealthCare.gov. “Preventive Care Benefits for Adults.” Accessed Aug. 8, 2016. https://www.healthcare.gov/preventive-care-adults/

[4] HealthCare.gov. “Preventive Care Benefits for Children.” Accessed Aug. 8, 2016. https://www.healthcare.gov/preventive-care-children/

These products are not qualifying health coverage (“Minimum Essential Coverage”) that satisfies the health coverage requirement of the Affordable Care Act. If you don't have Minimum Essential Coverage, you may owe an additional payment with your taxes. The termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period. These products may include a pre-existing condition exclusion provision.

About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual specialty benefit products, including disability, supplemental health, pet, and group life insurance through its subsidiaries since 1980. The IHC Group owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), and IHC Specialty Benefits, Inc., a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers.

About IHC Specialty Benefits
IHC Specialty Benefits, Inc. (IHC SB) is a technology-driven, full-service marketing and distribution company that focuses on small employer and individual consumer products through general agents, telebrokerage, advisor centers, and private-label arrangements. IHC SB conducts business under the following brands: Healthedeals.com; Health eDeals Advisors; Aspira A Mas; and PetPlace.com. For more information about IHC SB visit http://www.ihcgroup.com/companies.

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This Could Be Your Plan

Posted Apr 21, 2017
By Jenifer Dorsey

This Could Be Your Plan

You need health insurance, and you need it soon. But there’s a bit of a problem: Open enrollment for 2017 Obamacare plans ended January 31, and you do not qualify for a special enrollment period to purchase one now.

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Didn’t Buy Health Insurance? 15 Obamacare Exemptions That May Help You Avoid the Tax Penalty

Posted Apr 12, 2017
By Jenifer Dorsey

Didn’t Buy Health Insurance? 15 Obamacare Exemptions That May Help You Avoid the Tax Penalty

 

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Ask Frank: Will the Individual Mandate, Tax Penalty Be Enforced?

Posted Apr 10, 2017
By Jenifer Dorsey

Ask Frank: Will the Individual Mandate, Tax Penalty Be Enforced?

 

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What is Community Rating?

Posted Apr 08, 2017
By Jenifer Dorsey

What is Community Rating?

As the GOP revisits its plan to repeal and replace the Affordable Care Act (i.e., ACA, Obamacare), Vice President Mike Pence has attempted to sweeten the deal for members of the House Freedom Caucus.[1] Pence this week offered to eliminate or change three Affordable Care Act regulations: essential health benefits, guaranteed issue coverage and community rating.[2]

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Do You Need Health Insurance This Year?

Posted Apr 07, 2017
By Jenifer Dorsey

Do You Need Health Insurance This Year?

Since 2010, when President Obama signed the Affordable Care Act into law, the nation’s uninsured population has dropped to its lowest rate in the 25 years CDC’s National Health Interview Survey has reported such data: less than 10 percent.[1] In the first nine months of 2016, the percentage of people who were uninsured at the time of the interview was 8.8 percent compared with 16 percent in 2010.[2]

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Are Health Insurance Premiums Tax Deductible?

Posted Apr 07, 2017
By Jenifer Dorsey

Are Health Insurance Premiums Tax Deductible?

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New Rules May Limit Your Short-Term Coverage Plans

Posted Apr 04, 2017
By Jenifer Dorsey

New Rules May Limit Your Short-Term Coverage Plans

As the Trump administration continues to debate the future of the Affordable Care Act, a new Obama-era health insurance rule is taking effect. It’s a rule that changes temporary coverage as we know it.

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Lack of Support Trumps GOP Healthcare Bill

Posted Mar 28, 2017
By Jenifer Dorsey

Lack of Support Trumps GOP Healthcare Bill

As you’ve likely heard by now, the GOP pulled its Obamacare replacement bill before it could go to a vote on Friday, March 24. Now what? Is that the end of Trump’s promise to repeal and replace the Affordable Care Act? Will politicians draft another bill?

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