The Baucus Bill: What the Plans Must Offer
From pages 17-18:
All plans must provide preventive and primary care, emergency services, hospitalization, physician services, outpatient services, day surgery and related anesthesia, diagnostic imaging and screenings (including x-rays), maternity and newborn care, pediatric services (including dental and vision), medical/surgical care, prescription drugs, radiation and chemotherapy, and mental health and substance abuse services that at least meet minimum standards set by Federal and state laws. In addition, plans could charge no cost-sharing (e.g., deductibles, co-payments) for preventive care services, except in cases where value-based insurance design is used. Plans could also not include lifetime limits on coverage or annual limits on any benefits. Any insurer that rates on tobacco use must also provide coverage for comprehensive tobacco cessation programs including counseling and pharmacotherapy (prescription and non-prescription).
The plans, in other words, have to offer comprehensive coverage. This is much better than what many people get now. But given the insufficiency of the total funding, the question is how much cost-sharing is allowed in these plans. More on that in a moment.
September 16, 2009; 12:47 PM ET
Categories: Health Reform
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