CoverPlus Health Plans
Understanding Health Plan Benefits
The Summary of Coverage and Benefits (SBC) document is an excellent tool for understanding a health plan’s benefits. The document will detail coverage examples for the health plan and will provide an overview of what is covered. The SBC will be provided to you at the time of enrollment or shopping for coverage. It will also include a summary of the specifics of the coverage plan. Read this carefully and compare it to what other plans offer.
If you have specific questions about your health plan benefits, you can contact your insurance company. Calling the customer service number on the back of your health plan’s card is a good idea. A customer service representative can answer your questions about your health plan benefits. You can also contact the Marketplace Call Center, which can help you find the information you need. Just call 8 p.m. local time to speak to an insurance representative. Once you know the information you need, you can choose your health care provider or medical center.
You can also check the list of covered services online. Health insurance plans must cover a minimum of 10 different categories of services. These include medical services provided by doctors, inpatient, and outpatient hospital stays, prescription drugs, and mental health services. Some plans may cover more than 10 different services. Dental coverage for children is required by law, but it’s optional for adults. State requirements also may determine the specific services, a health plan must provide.