The future health insurance exchange plans (as well as most other commercially available plans) will need to offer a standardized (state-specific) Essential Benefit Package once the Affordable Care Act kicks in on 1/1/14. There are 10 key service categories that future plans will need to cover- including behavioral health services.
States were responsible for picking a plan from a set of existing options to serve as their state’s “benchmark” plan by last week. Arizona picked the State Employee EPO plan as the benchmark plan that most insurance plans will need to cover (at a minimum) on and off the exchange. Future exchange health plans (as well as most other commercially available plans) will need to be “substantially equal” to the state employee benchmark plan in the scope, limitations and exclusions (e.g. visit limits). I think the plan is a good choice because it has a robust behavioral health component with fewer limitations, restrictions and exclusions than most other options- and already covers behavioral health services at parity (meaning behavioral health has the same level of coverage as physical health).
Obviously there’s a lot more to it than that… and folks can get a lot more in-depth info about what an Essential Health Benefit is and what it means in this document– which provides an Arizona specific analysis of the issues and the various services that’ll be covered under the future benchmark plan.
Obviously there’s a lot more to it than that… and folks can get a lot more in-depth info about what an Essential Health Benefit is and what it
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