What are Essential Health Benefits?
The ACA requires all health plans offered to individuals and small group employers to include a comprehensive package of benefits and services known as Essential Health Benefits.
The Essential Health Benefits categories include:
- Ambulatory patient services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including dental and vision care
Plans must cover these benefits in order to be certified and offered in the health insurance marketplace. All Medicaid / Medi-Cal state plans must also cover these services by 2014.