Podcast Center
Video Center
Webcasts
Resource Center
Events
January 10, 2014 at 10:20 AM
Health plans can leave out spending on liposuction and massage therapy when deciding whether an enrollee has reached the annual out-of-pocket spending limit.
A plan also can leave out spending on out-of-network products and services, or any amounts that out-of-network providers charge that exceed the plan’s reimbursement level.
Officials from the Center for Consumer Information & Insurance Oversight, the Employee Benefits Security Administration and the Internal Revenue Service have given that advice in a collection of answers to questions about the Patient Protection and Affordable Care Act.
The new batch of guidance includes details about the new decision by CCIIO’s parent, the U.S. Department of Health and Human Services, to require all non-grandfathered major medical plans to include coverage for breast cancer prevention drugs in their basic preventive services package.
The officials also discuss the expatriate plans that cover overseas workers, wellness programs, and mental health parity rules.
The officials repeat earlier statements, for example, that grandfathered individual and small group plans need not provide mental health or substance abuse benefits.
