Guides

Essential Health Benefits

What are the 10 Essential Health Benefits?
tl;drAll plans under the Affordable Care Act must cover a list of 10 health categories deemed essential. See the list below.

Health insurance companies must cover 10 health benefit categories deemed essential by the Affordable Care Act. Certain plans may cover more than these benefits, and coverage of specific services may vary from one state to another. But every plan must cover the following list of essential health benefits at a minimum:

  1. Outpatient care that doesn’t require being admitted to the hospital (also known as ambulatory patient services)
  2. Hospitalization (like surgery and overnight stays)
  3. Pregnancy, maternity, and newborn care (both before and after birth)
  4. Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)
  5. Prescription drugs
  6. Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  7. Laboratory services
  8. Preventive and wellness services and chronic disease management
  9. Pediatric services, including oral and vision care (however, adult dental and vision coverage are not essential health benefits)
  10. Breastfeeding and birth control coverage

All health insurance plans on Catch cover the Essential Health Benefits. Catch makes it easy to compare all the options in your specific area to find the best coverage and the best price.