Individual MEC Plan

Individual MEC Plan

100.00

EBA Essential Plans provide affordable coverage that meets the requirements under the Affordable Care Act, which avoids members from paying the “Individual Mandate” penalty. This plan provides 100% coverage when utilizing a First Health Network provider and 0% coverage when utilizing an out-of-network provider.

*Please note that this plan is not insurance. The membership term of this plan is for a period of a year. In the event of an early termination, there is a 6 month waiting period for all services. EBA’s MEC Plans do not provide comprehensive major medical coverage, they do not intended to replace major medical insurance, and do not meet the minimum value requirements under the Affordable Care Act or Massachusetts M.G.L. c. 111M and 956 CRM 5.00. If you are qualified to receive a tax credit or subsidy in a plan under the Health Insurance Exchange and you enroll in this plan, you may not be able to receive the tax credit or subsidy before the next exchange open enrollment unless you have a qualifying life event. This plan contains a 30-day written cancellation period.

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Covered Services for Adults

  • Blood Pressure screening for all adults

  • Cholesterol screening for adults of certain ages or at higher risk

  • Type 2 Diabetes screening for adults with high blood pressure

  • Colorectal Cancer screening for adults over 50

  • Aspirin use for men and women of certain ages

  • Tobacco Use screening for all adults and cessation interventions for tobacco users

  • Obesity screening and counseling for all adults

  • Diet counseling for adults at higher risk for chronic disease y

  • Depression screening for adults

  • Alcohol Misuse screening and counseling

  • Immunization vaccines for adults - doses, recommended ages, and recommended populations vary: Hepatitis, Hepatitis B, Herpes, Herpes, Zoster, Human Papillomavirus, Influenza (Flu Shot), Measles, Mumps, Rubella, Meningococcal, Pneumococcal, Tetanus, Diphtheria, Pertussis, Varicella

  • Breast Cancer Mammography screenings every 1 to 2 years for women over 40

  • Well-woman visits to obtain recommended preventive services

  • Contraception coverage for women: Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling, not including abortifacient drugs

Covered Services for Children

  • Autism screening for children at 18 and 24 months
  • Behavioral assessments for children of all ages; Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Depression screening for adolescents
  • Immunization vaccines for children from birth to age 18 - doses, recommended ages, and recommended populations vary: Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b, Hepatitis A, Hepatitis B, Human Papillomavirus, Inactivated Poliovirus, Influenza (Flu Shot), Measles, Mumps, Rubella, Meningococcal, Pneumococcal, Rotavirus, Varicella
  • Obesity screening and counseling
  • Vision screening for all children
  • Iron supplements for children ages 6 to 12 months at risk for anemia
  • Alcohol Misuse screening and counseling
  • Medical History for all children throughout development; Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, and 15 to 17 years.
  • Oral Health risk assessment for young children; Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
  • Developmental screening for children under age 3, and surveillance throughout childhood
  • Height, Weight and Body Mass Index measurements for children; Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, and 15 to 17 years
  • Fluoride Chemoprevention supplements for children without fluoride in their water source
  • Hearing screening for all newborns
  • Hematocrit or Hemoglobin screening for children