Essential Health Benefits

What are Essential Health Benefits?

The ACA requires all new insurance plans to offer basic coverage within each care category in order to be considered comprehensive. These benefits include:

Preventive and wellness services

Chronic disease management

Ambulatory or outpatient services

Emergency services and hospitalizations

Laboratory services

Pregnancy, maternity and newborn care

Mental health and substance abuse treatment

Pediatric services, including pediatric dental and vision

Prescription drugs, including brand name and generic medications

Rehabilitative, rehabilitative services and medical devices

Although new plans must have a minimum amount of coverage in each of the Essential Health Benefits, the exact amount of coverage may vary depending on the actual plan you choose. You have options for additional coverage and financial reimbursement through supplemental plans if desired.