What does health insurance cover?

A wide array of health insurance plans that offer ranging benefits and access to different hospitals, doctors and other providers exist today. The Affordable Care Act mandated that all health plans in both the small group and individual markets provide a comprehensive package of services. These are qualified as essential health benefits and include the following 10 categories:

  • Ambulatory Patient Services
  • Emergency Services
  • Hospitalization
  • Maternity and Newborn Care
  • Mental Health and Substance Use Disorder Services, including Behavioral Health Treatment
  • Prescription Drugs
  • Rehabilitative and Habilitative Services and Devices
  • Laboratory Services
  • Preventive and Wellness Services and Chronic Disease Management
  • Pediatric Services, including Dental and Vision Care