The Ins and Outs of Comprehensive Insurance

It’s important to know and understand your benefits so you can get the most out of your insurance coverage. Comprehensive insurance guarantees you a minimum amount of healthcare coverage for each area and type of medical service that you may encounter, including for example, doctor visits, prescription drugs, hospital stays, chronic medical care and/or surgery. The defined categories of well-rounded coverage are outlined in what’s called the Essential Health Benefits.

Certain key elements appear in all comprehensive healthcare plans:

    • Primary Care includes basic healthcare services, usually delivered by physicians and trained medical personnel who practice family medicine, pediatrics, or internal medicine. A primary care physician is your main healthcare provider and usually your first point of contact. This physician will deliver preventive services and may refer you to specialists.
    • Specialty Care extends beyond primary care to medical fields such as surgery, cardiology or oncology. Specialists are doctors who have trained more deeply in specific medical or treatment areas to gain a more detailed level of expertise.
    • Urgent Care centers are same-day clinics that can handle a variety of injuries and conditions that require care but are not serious enough to require an emergency room. They offer a wide range of services for common illnesses that are not considered a true emergency including severe sore throats, minor sprains and cuts requiring stitches.
    • Emergency Care is required for any medical condition that poses an immediate danger to a person’s life or health. Head injuries, weakness, paralysis or persistent chest pain are true emergencies and are among those conditions that require emergency care.
    • Preventive Care includes testing, screenings and immunizations. Well-baby care, children’s vision exams, periodic prostate exams, pap smears and mammograms are all examples of commonly covered preventive care services. The ACA requires most insurance plans to provide preventive services without incorporating deductibles, co-payments, or co-insurance payments from you, allowing you to participate in these services without an expense.

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