What are essential benefits?
Who is this for?
This information will help you if you're shopping for health insurance and have questions about what's included in every plan.
There are some health care benefits you can count on getting no matter what plan you choose. The Affordable Care Act requires that all plans cover essential health benefits for individual and family plans and small group plans.
All of our plans offer these required essential health benefits:
- Outpatient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric vision
Some of these benefits, like preventive services, will be paid at 100 percent with no copay. We'll pay for the other benefits after you meet your deductible. Depending on the plan you choose, you may still be responsible for paying a copay and coinsurance.
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