How Does the ACA Protect Me?
The Affordable Care Act requires insurance companies to comply with all of the requirements below that further ensure that individuals are able to access timely and affordable coverage.
- Insurance companies may no longer deny coverage or charge people more for pre-existing conditions.This means individuals with a mental illness or substance use disorder cannot be denied coverage or charged more than other individuals.
- Insurance companies can no longer implement annual or lifetime limits on coverage or benefits.This means that you cannot exhaust your insurance benefits over a year or a lifetime.
- As a part of the Essential Health Benefits, all individual and small group plans must include mental health and substance use disorder benefits at parity as of 2014. Maryland’s Essential Health Benefit Plan that must be included in all Qualified Health Plans includes a robust package of mental health and substance use disorder benefits. These benefits include a full complement of services: inpatient, outpatient, partial hospitalization, intensive outpatient, and residential treatment for mental health and substance use disorders.
- All Qualified Health Plans must meet certification standards, which include a requirement that the insurer have an adequate network of providers, including a sufficient number of mental health and substance use disorder providers so that individuals may access treatment without unreasonable delay.