Qualified health plans (QHP) in combination with ACA compliant off-exchange plans are basically the new comprehensive major medical health plans. The Affordable care act (ACA) established that all health insurance plans must meet certain requirements (such as containing 10 essential health benefits, and having no annual of lifetime maximums for example). These requirements must be met by all health insurance plans going forward, whether they are purchased “on-exchange” (via healthcare.gov for example) or directly from private health insurance companies (off-exchange). There are a few temporary exceptions to this rule for plans purchased off-exchange. Off-exchange plans are technically not QHPs even though they still must confirm to a minimum set of benefits identical to the standards that QHPs are held to because in order to be sold on Federal or state marketplaces plans must be certified by the exchange. This is what makes them a “qualified health plan”
Essential Health Benefits
The ten essential health benefits that all QHPs must contain include
- Outpatient care (when not admitted to hospital)
- Coverage for visits to the Emergency room
- Inpatient care (when admitted to the hospital)
- Maternity benefits (care both before and after the baby is born)
- Mental health and substance abuse treatment (including behavioral health treatment, counseling, and psychotherapy)
- Prescription drug coverage
- Services and devices to help you recover if you are injured, or have a disability or chronic condition.
- Lab tests
- Preventive services
- Pediatric services (including both dental and vision coverage for children)
To obtain FREE no obligation quotes on qualified health plans or corresponding off-exchange health plans you can enter your zip code in the right hand column of this page to begin or call Toll-free (888) 592-5448.