Benefits of Coverage

All health plans offered through Access Health CT include coverage for ten important Essential Health Benefits to keep you and your family healthy, including:

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Emergency room coverage
• Hospitalization (such as surgery and overnight stays)
• Pregnancy, maternity and newborn care (care before and after birth)
• Mental health and substance abuse services, including behavioral health treatment (includes counseling and psychotherapy)
• Prescription drug coverage
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Laboratory service coverage
• Preventive and wellness services and chronic disease management
• Pediatric services (including oral and vision care for people under the age of 26)

Plans must also include birth control coverage and breastfeeding coverage. You can learn more in this article on Essential Health Benefits (opens in a new window).

Some plans offer many additional covered benefits. Specific services covered in each benefit category can vary, so check the Plan Details to see what is covered. Plans may offer additional benefits, including:

• Limited adult dental coverage
• Limited adult vision coverage
• Medical management programs (for specific needs like weight management, back pain and diabetes)

Preventive Care to Keep You Healthy

Most health plans must cover a set of preventive services—like vaccines and health screenings—at no cost to you. These services are available at no cost only when delivered by a doctor or other provider in your plan’s network.

Getting preventive care, such as annual checkups which can help you detect or prevent illnesses or diseases from becoming major issues, are the best way to keep your healthcare costs low. Often, you can start using your benefits right away, without having to pay your deductible. You can look at your plan documents to identify those benefits or check with your insurance company to see which benefits your plan covers.

Health insurance can be complicated. It’s important to understand your plan and the benefits available to you. Use our glossary of health insurance terms or contact your health insurance company if you need help.

Your Insurance Company

To get the most out of your health plan, make sure you get to know your benefits and your insurance company. Each insurance company offers a broad array of useful information to help you make the most of your plan.

They can help you:

• See what’s covered by your plan
• Pay your premium bill
• Get your ID card
• Find in-network doctors & pharmacies
• Check your prescription drug coverage