What is an essential health benefits package?

Essential health benefits packages are packages of health care services that insurance companies, in North Carolina, are required to provide. These packages generally include physician visits, prescription drugs, mental health and substance abuse services, laboratory and imaging services, emergency services, and hospitalizations. These packages are the same across health plans in North Carolina, guaranteeing all residents have access to the same level of care no matter their insurance provider. Additionally, health plans are required to cover preventive services at no extra cost to the insured. This means residents with an essential health benefits package may receive routine vaccinations, cancer screening, and other tests without paying out of pocket for them. Essential health benefits packages protect North Carolina residents in other ways, too. Insurance companies are not allowed to charge higher premiums for people with pre-existing conditions like diabetes and cancer. The packages also cap out-of-pocket expenses at $8,150 for an individual and $16,300 for family coverage. Essential health benefits packages guarantee North Carolina residents access to a full range of health care services at a reasonable, predictable cost. This allows people to plan out their healthcare expenses and receive the care they need without fear of financial hardship.

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What is an essential health benefits package?

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