M.E.C.

Understanding the Minimum Essential Coverage or ( MEC )

Minimum essential coverage is a collection of items within a health insurance policy that covers a certain set of procedures, treatments or prescriptions. M.E.C. was mandated by the ACA to provide a standard of covered items.

Here they are

Prescription Drugs

Pediatric Services

Preventive and Wellness Services and Chronic Disease Management

Emergency Services

Hospitalization

Mental Health and Addiction Services

Pregnancy, Maternity, and Newborn Care

Ambulatory Patient Services

Laboratory Services

Rehabilitative and Habilitative Services and Devices

Here is a more detailed explanation of each M.E.C.

1. Prescription Drugs

Within the federal government database of approved prescription drugs, to be MEC compliant one drug from each category must be covered, and made available to policyholders.

2. Pediatric Services

Coverage for children includes dental care, vision care, well-child visits, vaccinations, and immunizations. Dental and vision care must be offered to children through the age of 18 (two routine dental exams; one yearly eye exam with corrective lenses).

3. Preventive and Wellness Services and Chronic Disease Management

Coverage for a range of services such as diet counseling, colorectal cancer screening, Type 2 diabetes screenings, and immunization vaccines.

4. Emergency Services

Urgent care such as a trip to the emergency room where you truly need care as soon as possible. This also means that you won’t be penalized if the hospital is out of network.

5. Hospitalization

Procedures and treatment you receive in the hospital as part of inpatient care. Plans may limit coverage for extended stay.

6. Mental Health and Addiction Services

Such as recovery services for drug addiction, behavioral health, provide counseling, or provide psychotherapy.

7. Pregnancy, Maternity, and Newborn Care

Services that care for you and your baby before, during, and shortly after giving birth.

8. Ambulatory Patient Services

Treatment received on an outpatient basis, care you receive without being admitted to the hospital.

9. Laboratory Services

Blood work or testing to diagnose, to gauge effectiveness, and some preventive screenings.

10. Rehabilitative and Habilitative Services and Devices Aftercare services help you recover if you are injured, have a disability, or have a chronic condition. Services may include physical therapy, occupational therapy, or speech therapy.