Tutorial: 10 essential benefits of Affordable Care Act coverage
Under the Affordable Care Act, health insurance plans offered to individuals must cover 10 essential benefits.
Posted — UpdatedThat means the plans will cost more, but coverage is also more comprehensive.
The 10 essential health benefits are as follows:
- Ambulatory services, which is outpatient care people receive without being admitted to a hospital
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including counseling and psychotherapy
- Prescription drugs
- Rehabilitation services and devices, including anything that helps people with injuries, disabilities or chronic conditions gain or recover mental and physical skills
- Laboratory services
- Preventive and wellness services, such as shots and screening tests for everything from high cholesterol and diabetes to cancer and sexually transmitted diseases
- Pediatric services
All health plans offered through the online exchange, as well as other plans offered directly by insurers or through agents, must cover the 10 services without charging a co-payment or co-insurance, even if a patient hasn't met a yearly deductible.
The 10 benefits are the minimum requirements for all plans in the marketplace, but some plans may offer additional coverage.
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