All private health insurance plans offered in the Health Insurance Marketplace® must cover the same essential health benefits. Care in these 10 categories of services is covered by all Marketplace plans.
10 covered benefits:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment, counseling, and psychotherapy
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (this doesn’t include adult dental or vision coverage)
In addition, plans must also include birth control and breastfeeding coverage. Some plans may offer dental and vision coverage.
Specific services may vary based on your state’s requirements. Get more information on what Marketplace health insurance plans cover.
Related Articles
Value-Based Care Is a Four Layer Cake — Why Do We Only Focus on The Icing?
During a recent panel discussion, three healthcare experts discussed reasons why value-based...
Value-Based Care Is a Four Layer Cake — Why Do We Only Focus on The Icing?
During a recent panel discussion, three healthcare experts discussed reasons why value-based...
State Reported Efforts to Address Health Disparities: A 50 State Review
This analysis focuses on current state efforts, many of which were implemented...
State Reported Efforts to Address Health Disparities: A 50 State Review
This analysis focuses on current state efforts, many of which were implemented...
Leave a comment