10 REQUIRED BENEFITS
Insurers have to offer at least 10 essential benefits, Walker said. The required benefits are: access to ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental-health and substance-use disorder services; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive/wellness services and chronic-pain management; and pediatric services.
SILVER AND GOLD
Another goal of the Affordable Care Act is to standardize benefits and costs to consumers.
In New York, insurers can offer plans on four levels — bronze, silver, gold and platinum — with varying levels of benefits and consumer contributions. They don’t have to offer plans on all four levels, but to take part in New York State of Health and other exchanges, they must offer at least a silver and a gold plan.
Walker said some of the benefits of the Affordable Care Act are restrictions on denial of coverage due to pre-existing conditions and a prohibition on dropping coverage if someone becomes ill.
The Adirondack Health Institute is a joint venture of Adirondack Health, Community Providers Inc. and Hudson Headwaters Health Network. It is one of several health-care navigators that have been created as the Affordable Care Act takes effect.
Douglas said the chamber is part of the New York Benefits Alliance, a coalition of seven Upstate chambers with more than 9,000 health insurance accounts.
He said people can get assistance in choosing insurance through navigators such as the Adirondack Health Institute, the chamber’s Plattsburgh-North Country Service Corporation or their own insurance broker.
“The North Country Chamber of Commerce is in the health-insurance business for small employers and the self-employed,” he said. “We’re ahead of the curve there.”
Walker said the main thing is to realize assistance is available.
“You don’t have to do this alone,” she said.
For more information, visit www.nystateofhealth.ny.gov or www.adirondackhealthinstitute.org.
Email Dan Heath:email@example.com