How Health Reform Affects Disability Care
If you have a disability -- or your child does -- you can't be turned down for insurance because of a disability. You may pay less for care. You may also have greater access to the treatment you need.
Both physical and mental disabilities qualify. Some examples include:
- You had a stroke and it has affected your speech, vision, or movement.
- Your child is a young adult with autism spectrum disorder that has kept him or her from getting a job and living independently.
- You have a slipped disc that makes it impossible for you to work.
- You have bipolar disorder, which has kept you from getting or keeping a job.
Essential Health Benefits
By law, all health plans sold in state Marketplaces, on the individual market, or through small employers must cover a list of 10 "essential health benefits." This includes care that can help you manage your disability. These benefits include:
- Rehabilitation services. This is a type of treatment that helps you regain function you lost because of your condition. You can also get habilitative services, treatment that helps you learn and develop skills important to your daily life.
- Mental health services. Insurers must cover counseling for mental illnesses like bipolar disorder or schizophrenia. You can also get medicine for your condition. And you can get a screening for depression without having to pay an additional cost for the visit.
- Chronic disease management. You can get help managing chronic health conditions such as arthritis and heart disease.
Insurance companies that sell health plans through your state's insurance Marketplace must include these essential health benefits. Older health plans with “grandfathered” status don't have to cover the essential health benefits package. Neither do large employer plans, though most cover them anyway. Be sure to check the details of what your plan covers before seeking care.