All health insurance plans offered in the individual and small group market must now meet a number of requirements.
These requirements apply to plans both inside and outside the formal ACA Marketplace.
The essential health benefits required by the ACA include:
- Ambulatory patient services
- Emergency services
- Coverage for hospitalization
- Care for pregnant women and newborn babies
- Mental health and substance use disorders, including treatment for behavioral health
- Prescription drugs
- Rehab services
- Laboratory services
- Preventive and wellness services
- Management for chronic illnesses
- Pediatric services, including vision and dental care