Health Insurance

Unified Financial Group also offers health insurance for everyone under 65 through the ACA Marketplace.

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What Marketplace Health Plans Cover

All plans offered in the Marketplace cover these 10 essential health benefits:

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Emergency services
• Hospitalization (like surgery and overnight stays)
• Pregnancy, maternity, and newborn care (both before and after birth)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Prescription drugs
• Rehabilitative 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, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

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Plans must also include the following benefits:

• Birth control coverage
• Breastfeeding coverage

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Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements. Plans may offer additional benefits, including:

• Dental coverage
• Vision coverage
• Medical management programs (for specific needs like weight management, back pain, and diabetes)

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Are you eligible to use the Marketplace?

To be eligible to enroll in health coverage through the Marketplace, you:

• Must live in the United States
• Must be a U.S. citizen or national (or be lawfully present)
• Can’t be incarcerated

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You can get health coverage during the Open Enrollment Period, which starts November 1.

Certain life events, like losing health coverage, moving, getting married, having a baby, or adopting a child, may qualify you to enroll in or change Marketplace health plans outside the yearly Open Enrollment Period.

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Common Coverage Questions

Once you’re enrolled in a health plan and your coverage has started, you can use it to help cover medical costs for services like:

• Filling a prescription at the pharmacy
• Going to the doctor
• Getting emergency care

If you haven’t had private health insurance before or if it’s been a while, you may want to learn about using your coverage and improving your health using our “From Coverage to Care: A Roadmap to Better Care and a Healthier You” (PDF).

If your health insurance company doesn’t pay for a specific health care provider or service, you can appeal an insurance company decision.

Unsure about your coverage? Learn what to do if you’re not sure you’re enrolled, or haven’t received your insurance card.

Learn more if your new coverage is through your state’s Medicaid or CHIP program.