Federally and state mandated health insurance works to ensure that everyone is covered equally, no matter what their health is like.
There are two main types of government mandated insurance benefits; Federal mandated insurance, and state mandated insurance. Federally mandated health insurance regulations are laws that affect the entire country and how health- insurance companies treat their policyholders. State mandated health-insurance regulations are put into place to ensure that certain procedures, such as infertility treatments, are covered by the health-insurance industry.
Federal Mandated Health Benefits
Federally mandated health benefits range from statutes that require health plans to cover services by chiropractors and optometrists to requirements for specific diagnostic/treatment services such as mammograms, inpatient hospital care after a woman delivers a baby, or laws that extend benefits to certain populations such as continuation coverage of employees or dependents. For instance the Newborns' and Mothers' Health Protection Act of 1996 states that a health-insurance policy may not limit benefits for any hospital length of stay related to childbirth for the mother or newborn child.
Patient Protection and Affordable Care Act
Passed on Sept. 23, 2010, this act has removed the lifetime benefit cap for essential health services such as ambulatory patient services, hospitalization, emergency services, chronic disease management, lab services, maternity and newborn care, preventive and wellness services, and prescription drugs. Under this act health-insurance providers cannot cancel your coverage for medical reasons, and they must provide full coverage of preventative health care that is recommended by the Center for Disease Control, such as immunizations.
COBRA
The Consolidated Omnibus Budget Reconciliation Act (COBRA) was created to help employees, and their immediate family, who lose medical benefits to have continued access to an employer-sponsored group plan. COBRA provides temporary health coverage for employees, their spouses, ex-spouses, and dependents. If you are currently or were recently employed by a company with more than 20 employees and were offered health insurance, you may qualify for COBRA. The events that qualify someone to be eligible for COBRA are termination of employment, reduction of working hours, divorce, or loss of dependent status. COBRA benefits include physician care, inpatient and outpatient hospital care, surgery, and prescription drugs. Some COBRA providers may also cover dental and vision care.
Mental health benefits
The Mental Health Parity and Addiction Equity Act of 2008 is the most recent federal law for behavioral health coverage. This federally mandated health insurance requires health-insurance providers to cover mental-health and substance-abuse treatments in a manner comparable to the coverage offered for other medical benefits. This means that if you need mental health care or hospitalization for substance abuse, you would pay the same for it as other types of health insurance plans.
State Mandates
State legislators add laws that apply only in their state when the federal government has not addressed certain health issues that the state feels should be protected. Infertility treatments is an example. As of October 29, 2010, fifteen states have laws requiring health insurance companies to cover infertility treatments. These states are Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia. The mandate is different in each state. For example, in California the mandate say that group insurers must cover all infertility treatments except in-vitro fertilization.
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