Essential Health Benefit Coverage

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All private health insurance plans offered in the Marketplace offer the same set of essential health benefits. Following are services all plans must cover:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (such as surgery)
  • Pregnancy, maternity, and newborn care (care before and after your baby is born)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services

Additional benefits
Essential health benefits are minimum requirements for all plans in the Marketplace. Plans may offer additional coverage. You will see exactly what each plan offers when you compare them side-by-side in the Marketplace.
Additional benefits include:

  • Birth control benefits
  • Breastfeeding benefits
  • Dental coverage

 Here are some Important dates and deadlines:
Nov. 15, 2014: Open enrollment starts. This is the first day you can apply for 2015 coverage
Dec. 15, 2014: The last date to enroll for coverage that starts January 1, 2015
Dec. 31, 2014: Date when all 2014 Marketplace coverage ends, no matter when you enrolled
Jan. 1, 2015: The date 2015 coverage can start if you apply by Dec. 15, 2014, or if you accept automatic enrollment in your 2014 plan or a similar plan
Feb. 15, 2015: The last day to enroll in 2015 coverage. If you miss this deadline, you can’t sign up for a health plan inside or outside the Marketplace for the rest of 2015. The only exception is if you qualify for a special enrollment period.
Find local help
For your convenience, here is a list of agencies to contact with questions or concerns regarding enrollment for health coverage.
Detroit Health Care For The Homeless dba Advantage Health Centers
Phone: (313) 835-5990
Email: administration@advantagehealthcenters.org
Web: https://ahcdetroit.org
Address: 79 West Alexandrine, Third Floor Detroit, MI 48201
 
Wayne State University Physician Group
Phone: (248) 581-5840
Email: financialcounselors@wsupgdocs.org
Web: https://www.wsupgdocs.org
Address: 3990 John R Detroit, MI 48201
 
Wellness Plan
Phone: (313) 875-4200
Email: cherrell@wellplan.com
Web: https://www.wellplan.com
Address: 21040 Greenfield Oak Park, MI 48237
 
PhysioFlex, PLLC.
Phone: (248) 440- 7102
Email: tjones.physioflex@yahoo.com
Address: 26250 Northwestern Highway Southfield, MI 48075
 
Covenant Community Care, Inc.
Phone: (313) 554- 0485
Email: jpettway@convenantcommunitycare.org
Web: https://www.convenantcommunitycare.org
Address: 20901 Moross Road Detroit, MI 48236
 
Small businesses and their employees can get help from the toll-free SHOP Marketplace call center
Phone: 1-800-706-7893 or for TTY, call 711.
More agencies can be found at localhelp.healthcare.gov
 

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