Essential Health Benefits
Insurance Glossary
The ten categories of care that individual and small group health plans must cover under the Affordable Care Act. They include hospitalization, emergency services, prescription drugs, maternity and newborn care, mental health and substance use treatment, and preventive services, and plans sold through the Marketplace must include all ten while short term plans and certain other arrangements are not required to. The specific services inside each category come from a benchmark plan that each state selects, so the details differ from state to state.
This content is for general informational purposes only and is not insurance, legal, or financial advice. Coverage, exclusions, eligibility, and pricing vary by insurer, by policy, and by state, and only the policy documents control what is covered. Always confirm the details of any coverage with a licensed insurance agent or the issuing carrier before you buy.
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