JS Downey Insurance Service Lic# 0501471

View Original

Good to Know: Essential Health Benefits

All health insurance plans now share some common characteristics. The Affordable Care Act requires that all health insurance plans offered in the individual and small-group markets must provide a comprehensive package of items and services, known as essential health benefits.

These benefits fit into the following 10 categories:

  • Ambulatory patient services.

  • Emergency services.

  • Hospitalization.

  • Maternity and newborn care.

  • Mental health and substance use disorder services, including behavioral health treatment.

  • Prescription drugs. For more information about prescription drug benefits, visit the page Prescription Drugs.

  • Rehabilitative and habilitative services and devices.

  • Laboratory services.

  • Preventive and wellness services and chronic disease management.

  • Pediatric services, including dental and vision care.

The requirement for insurance plans to offer essential health benefits is just one of many changes in health coverage that began in 2014.