Did you enroll in a Coventry Health Plan in Delaware from choosehealthde.com or healthcare.gov?
FYI: The Coventry Plans do not have any benefit coverage for cancer, severe infection, or severe kidney disease. Those plans do not cover chemotherapy, radiation therapy, infusion therapy, or dialysis. This includes a lack of coverage for KIDS, not just adults. Furthermore, the costs incurred by the patient for those treatments that they do receive are not eligible for inclusion in the accumulators for deductible or out-of-pocket max. The patient must therefore shoulder 100% of the financial burden for such treatment.
During enrollment, the Summary of Plan Benefits and Coverage (SBC) available online did not provide you with that information. The SBC's contain a list of benefit exclusions, however they do not mention the lack of coverage for life-saving therapies. Instead they state: "This isn’t a complete list of exclusions. Check your policy or plan document for other excluded services." The problem is, the actual policy or plan documents are not mailed to the insured person until after he or she has already enrolled in the plan and made their first payment! Apparently the government did not want anyone to know about these exclusions.
This void in plan benefits is not due to a loophole under the provisions of the ACA, but exists entirely by design. Unfortunately, the Government determined that cancer treatments, infusion therapy, and dialysis were not Essential Health Benefits (EHB's) (ya know, the American People would absolutely flip if they knew this!). The Architects of Obamacare decided upon 10 EHB's that all plans must include in order to provide Minimal Essential Coverage (MEC). They determined that the cost of providing cancer treatments or dialysis outweighed the benefit of saving the patient's life. They also apparently concluded that the benefit of providing birth control, substance abuse treatment, and pediatric dental and vision, and maternity benefits to EVERYONE outweighed the benefit of saving a cancer or kidney patient's life.
The Government knew that the only way to offer Obamacare plans that were "affordable " was to exclude benefits for very expensive life-saving treatments from some of the plans. They also knew that hardly anyone would be interested in selecting a plan that was severely deficient in life-saving treatment benefits. And, they knew that if those prospective insured persons could not afford the more expensive plans that did offer benefits for life-saving treatments, then they probably would not sign up for any Obamacare plan. In order to ensure that more people would sign up, the Government knew that they had to hide the fact that the more affordable plans excluded benefits for life-saving treatments. They made sure that the list of exclusions on the SBC's did not state the exclusions for life-saving treatments. That was egregiously deceptive, and morally reprehensible. The lives of some American citizens were considered expendable for the sake of the political success of Obamacare.
I do not for one second believe that Delaware is an isolated case. The Coventry plans are 40% of all plans offered in the Obamacare Marketplace in Delaware. I would venture to guess that probably 40% of all plans nationwide also exclude benefit coverage for chemotherapy, radiation therapy, infusion therapy, and dialysis.
If you enrolled in a Coventry plan in Delaware, or for that matter if you enrolled in any Obamacare plan nationwide, check the details of benefit coverage and exclusions in your Policy documents when you receive them.
P.S.: I thought you'd like to know:
I previously had a private insurance policy that was comprehensive enough for me, and I was happy with it. It didnot contain all 10 Obamacare-mandated EHB's. It covered MY definition of EHB's, and in my opinion my plan certainly qualified as providing MEC. My monthly premium was $167.00 per month.
I now have an Obamacare plan that has a monthly premium of $756.00, an increase of 353%. However, due to my income level, my fellow taxpayers are being forced to subsidize my premium to the tune of $367.00 per month, and I now pay $389.00 per month, an increase for me of 133%.
The thing is: I don't need the substance abuse treatment benefits. I don't need the maternity benefits. I don't need the pediatric dental and vision benefits. I may however eventually need the mental health benefits, because the Democrats are driving me crazy.