New Health Insurance Plan Requirements

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:

  1. Ambulatory patient services
  2. Emergency services
  3. Coverage for hospitalization
  4. Care for pregnant women and newborn babies
  5. Mental health and substance use disorders, including treatment for behavioral health
  6. Prescription drugs
  7. Rehab services
  8. Laboratory services
  9. Preventive and wellness services
  10. Management for chronic illnesses
  11. Pediatric services, including vision and dental care