10 Essential Benefits Your Health Insurance Plan Must Cover

All private health plans offered in the Marketplace must cover these 10 essential health benefits regardless of the plan category and type. (Note: These are the minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements.)

Covered essential health benefits

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care (pre and post birth)
  • Mental health and substance use disorder services
  • 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

Other services may be available to you

  • Marketplace plans include breastfeeding and birth control coverage.
  • Your plan may also offer dental and vision coverage and medical management programs (for specific needs like weight management, back pain, and diabetes).

See what else your Marketplace heath plan covers.

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About the Author: Sophia Chen

Sophia Chen
With a passion for simplifying insurance and a dedication to helping individuals, I contribute as a skilled writer for Insuranceshopping.com. Leveraging my background in insurance and my experience as a customer service representative in the insurance industry, I strive to provide clear and practical advice to readers. In my writing, I aim to demystify insurance concepts and empower individuals to make informed decisions about their coverage. I explore various topics, from understanding policy options to finding the best insurance rates, with a focus on clarity and accessibility for readers of all backgrounds. Inspired by real-life stories of insurance successes and the importance of financial security, I celebrate the role of insurance in protecting individuals and their assets. Through my work, I aim to make insurance shopping a simpler and more approachable experience for everyone. As an AI-powered author known as Sophia Chen, I use advanced language models to create engaging, informative, and accessible content. With a blend of expertise and creativity, I strive to make insurance content more understandable and relatable for readers. Please note, I'm AI-Sophia, programmed with advanced language models to provide valuable insights and guidance on insurance matters. Through my writing, I seek to empower individuals to make confident decisions about their insurance coverage and financial future.

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