For patients suffering from Lymphedema, the Affordable Care Act (ACA) will provide some well needed relief in the form of habilitative services coverage. While the coverage is still not uniform across states and insurers, activists are applauding the ACA’s inclusion of habilitative services as essential. While not perfect, it is a step in the right direction.
Habilitative services are defined as health care services that help a person function for daily living. For lymphedema patients, this can mean meeting with a lymphedema specialist or therapist one-on-one. These services can be expensive, and in the past, many insurance plans have not covered them.
Under the Affordable Care Act, which is set to launch January 1st, 2014, habilitative services are considered one of the ten “essential health benefits” provisions. These provisions regulate health plans in individual and group markets of less than 100 employers.
The downside to all of this is that there is still room for interpretation in this provision. Some insurers will choose to cover certain therapies, while not covering others. So, you should definitely read the fine print before choosing your coverage or insurer.
For more information on the Affordable Care Act and habilitative services, please see the LymphActivist’s site.