10 Essential Obamacare Benefits

Do you know the benefits of your health insurance?


Maybe you, as many millions of other Americans, do not have a health insurance plan or if you do, you don’t know the details about your plan. In this article we share with you the 10 essential benefits that your health insurance must offer according to the Affordable Care Act (ACA) Obamacare.


No. 1

Preventive Health Checkups

We are referring to all preventive check ups, including the control of chronic diseases. You must know that doctor visits to prevent diseases, just like the 50 procedures recommended by HealthCare.gov do not require a co-pay. This means you should receive these services/procedures absolutely free of charge if you have health insurance. 

These 50 procedures include visits to women care, detection of family violence, support during lactancy and pregnancy prevention.

No. 2

Pregnancy and Newborn care

Health services during pregnancy and after birth are considered essential health care services. This means that all authorized health insurance plans must cover these services without copay or coinsurance, even when you haven’t met your deductible. For more information about benefits during pregnancy visit HealthCare.gov

No. 3

Mental Health and Addiction Treatment

Just as your physical health, mental health is important and essential to take care of during the life of any person. Because of the COVID-19 pandemic, the anxiety levels of people has increased. Here, at Texas Medical Care Plans we want to make sure you have the necessary support to face and control your emotional adversities. Your health insurance must cover treatments for the control and abuse of substances such as alcohol and other hard drugs. If you need assistance, please don’t hesitate to contact us to find a plan that covers your needs. You are not alone!

No. 4

Services and equipment for disabilities, injuries, and other chronic conditions

This means your Obamacare plan must cover, at the very least, the equipment needed to recover from a temporary injury, such as a broken leg. The Affordable Care Act or Obamacare requires that your insurance also covers chronic illnesses such as multiple sclerosis and more.

No. 5

Lab Tests

All health insurance plans must cover the cost of lab tests needed by doctors to diagnose any disease. If lab tests are not done to help diagnose a disease or illness, you must pay the copay or other deductibles.

No. 6

Pediatric Services

At Texas Medical Care Plans, our priority is the health of your family, it is extremely important that you know the reach of your health benefits to cover medical expenses, regular visits and even dental  and eye care for your children.  Contact us to find the best plan suited to your needs and the needs of your family.  

No. 7

Prescription Drugs

Health plans will help pay the cost of certain prescription medications. You may be able to buy other medications, but medications on your plan’s “formulary” (approved list) usually will be less expensive for you. Contact us to find out, without charge, what medications are covered under your health insurance.

No. 8

Emergency Room Services

We never know when we could be in need of emergency room services. It is of extreme importance that you are informed about the details of your health insurance coverage for these type of situations. Most plans already include some type of coverage for these medical expenses, however, some of them might cover more than others, especially if you are taken care of at a hospital outside of your network or without prior approval of your insurance company. Please talk to one of our agents for more information.

No. 9

Outpatient Health Services

An outpatient health service is a procedure that can be done without having the patient stay the day at the clinic or hospital. This means you can receive the necessary medical care without having to be admitted to a healthcare facility for the night. Most of these outpatient services are taken care of the same day.

No. 10


Last but not least, you should know the length of your health insurance coverage in case of hospitalization. A regular hospitalization can include surgery or a treatment that can only be taken care of under medical supervision. 

People covered under Obamacare are protected against some of these expenses. It is important for you to know the extent of your coverage in case you need some of these services. Please contact us to give you detailed information about your plan coverage or to get a health insurance plan if you do not have one.


It is of the utmost importance that you know each and all of the ten Obamacare benefits and your coverage extent. If you are looking to change or obtain a health insurance plan then take advantage of this Special Enrollment Period available until May 15 to find the best coverage for your needs.

For more information about how to obtain the best available health insurance plan for you and your family, please call us for a free consultation with one of our agents. You might qualify for health insurance starting at $0/month.

Portrait of patient with doctor sitting at home

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