Does Obamacare Cover Surgeries?

Does Obamacare Cover Surgeries?

Obamacare was enacted in 2010 with the intention of drastically altering the US healthcare system. Its main objectives were to limit healthcare expenses, safeguard patients from discrimination, and expand insurance coverage. All insurance plans sold via the exchanges are required to provide a certain set of essential health benefits, as defined by the Affordable Care Act. Hospital stays, prescription medications, preventative care, and most importantly surgical procedures are among these benefits. Obamacare ensures that surgery is included in the essential health benefits that insurance carriers are required to provide since it is an essential part of healthcare.

READ: How Much Does Obamacare Cost Per Month?

What Does Obamacare Cover?

One of the primary objectives of Obamacare is to make healthcare more accessible and affordable for millions of Americans.Its key provisions aimed to increase insurance coverage, protect patients from discrimination, and control healthcare costs. However, the Obamacare initiative provides coverage for the following;

Ambulatory patient services (outpatient care you get without being admitted to a hospital)
Emergency services
Hospitalization (like surgery and overnight stays)
Pregnancy and newborn care (both before and after birth)
Mental health and substance use disorder services, including behavioural health treatment, counselling, and psychotherapy
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 (this doesn’t include adult dental or vision coverage).

READ: How Do Poor People Afford Surgery?

Types Of Surgeries Covered By Obamacare

Major and minor surgical procedures are among the many treatments for which Obamacare provides coverage. These consist of, but are not restricted to:

Emergency Surgery: Obamacare guarantees that operations connected to trauma, including appendectomies, are covered in order to stabilize and save lives.
Medically required Surgeries: Generally, insurance covers surgeries that medical specialists determine to be required. This covers operations such as organ transplants, cancer surgery, and heart surgeries.
Preventive Surgery: In an effort to encourage proactive healthcare, Obamacare covers some preventive operations, such as mastectomies for the prevention of breast cancer.
Outpatient Surgery: Obamacare also covers a number of outpatient operations, including hernia repairs and cataract removal.

Who Qualifies For Obamacare Surgeries?

In order to qualify for Obamacare’s surgical coverage, a person has to fulfil several requirements:

Enrollment in a Qualified Health Plan (QHP): You must enroll in a QHP via the Health Insurance Marketplace in order to receive the advantages of Obamacare. Every year, there are open enrollment times when you can choose or modify your plan.
U.S. citizenship or legal residency: You must be a citizen or legal resident of the United States in order to be eligible for Obamacare. There can be certain exclusions for immigrants with particular visa statuses.
Household Income: In order to qualify for Obamacare subsidies or financial aid, your household income must fall within a specific range. States have different income criteria.
Absence of Employer-Sponsored Coverage: You could not qualify for Obamacare coverage if you already have access to employer-sponsored health insurance that satisfies the standards for basic essential coverage.
Not incarcerated: Obamacare coverage is not available to those who are jailed at the moment. But when they’re released, they could be qualified.

READ: Who is Obamacare Good For?

Surgery is covered under Obamacare, often known as the Affordable Care Act. This includes pediatric, emergency, medically required, preventative, and outpatient procedures. In order to receive this coverage, people must enrol in a Qualified Health Plan (QHP) through the Health Insurance Marketplace and meet certain eligibility requirements. You may make the most of your healthcare coverage and guarantee that you get the surgery you want by selecting the appropriate plan, verifying network providers, getting preauthorization, and if needed, appealing rejections. Hope the provided information is helpful, kindly leave a comment below in the comment section.

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