When you shop and enroll in insurance, you can get a summary of benefits and coverage (SBC) offered by the plan, with easy-to-understand descriptions and examples that explain the benefits.
The SBC also has Coverage Examples to help explain the benefits offered for specific common health care scenarios like having a baby or managing Type II Diabetes.
The SBC is consistent across all health insurance plans and includes:
The items in the SBC represent an overview of coverage; they are not a complete list of what is covered or excluded. The full terms of coverage are located in the insurance policy.
When shopping for health insurance, you can request an SBC before you buy, but you must also get a copy at the time of application, enrollment, yearly upon re-enrollment and any time you ask for it.
The new law also requires health insurers to provide you with a uniform glossary. This is a list of commonly used insurance-related terms and medical terms that will help when comparing terms of coverage and medical benefits.
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