Affordable Health Insurance
The Affordable Care Act (ACA), commonly known as Obamacare, ensures comprehensive health insurance coverage for all Americans. The ACA mandates that all health plans cover a range of essential health benefits, providing you and your family with a robust safety net for various medical needs. Here’s a detailed look at the coverages included:
Essential Health Benefits
All ACA-compliant plans must cover the following ten categories of essential health benefits:
1. Outpatient care without being admitted to a hospital.
2. Immediate treatment for urgent health issues and accidents.
3. Inpatient care, including surgery and overnight stays.
4. Prenatal care, childbirth, and postnatal care for mother and baby.
5. Behavioral health treatment, counseling, and psychotherapy.
6. Medications prescribed by your healthcare provider.
7. Rehabilitative and Habilitative Services and Devices
8. Laboratory Services
9. Preventive and Wellness Services and Chronic Disease Management
10. Pediatric Services
Additional Protections and Coverages
☑️ Insurers cannot deny coverage or charge higher premiums for individuals with pre-existing conditions.
☑️ Preventive services, such as screenings, immunizations, and contraceptives, are covered without cost-sharing.
Get a Consultation
& Quote at No Cost
By submitting your information, you acknowledge a licensed insurance agent from Jerry Molina Health Insurance may contact you by phone, email, or mail to discuss and quote Medicare Advantage Plans, Medicare Supplement Insurance, or Prescription Drug Plan, and that you may unsubscribe at anytime by Replying STOP.
Jerry Molina Financial and Insurance Services, LLC
Copyright 2024 -- All Rights Reserved
Phone: (956) 342-9469
Email: [email protected]
General disclaimers
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.
Please contact Medicare.gov or 1–800–MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week or your local State Health Insurance Program to get information on all of your options.
Agency represents Medicare HMO, PPO, and PFFS organizations and stand-alone PDP prescription drug plans that have a Medicare contract. Enrollment depends on the plan’s contract renewal.
The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. To learn more about a plan’s nondiscrimination policy, please click any of the Nondiscrimination links above in the Health plan disclaimers section.
This information is not a complete description of benefits. Call 1-956-342-9469 (TTY: 711) for more information.
Medicare beneficiaries may also enroll in the plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
Every year, Medicare evaluates plans based on a 5-star rating system.
Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations.
Please call the Plan’s customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Total annual cost is calculated by adding up the total annual cost of any monthly premiums, applicable plan deductible(s) and estimates for all co-pay and co-insurance amounts that will be due for the medications and health benefits used throughout the year.
Costs for medications and health benefits vary across pharmacies and health systems, so the costs provided are only estimates. Actual costs could vary.
For plans with Part D Coverage: You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 8 a.m. and 7 p.m., Monday through Friday.
TTY users should call, 1-800-325-0778 or consult www.socialsecurity.gov; or your Medicaid Office.
You must have both Part A and B to enroll in a Medicare Advantage plan. Members may enroll in the plan only during specific times of the year. Contact the plan for more information.
The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
To send a complaint to a Medicare Health Plan, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.