Benefits Included in ACA Health Insurance Plans
When you shop for a health insurance plan, you will find a variety of options.
All ACA-compliant (Affordable Care Act) plans must include essential health benefits:
- Outpatient (ambulatory) patient services without being admitted to a hospital
- Emergency and life-saving services
- Hospitalization services including overnight stays and surgical procedures
- Preventative and wellness services
- Chronic disease treatment (like diabetes)
- Maternity, pregnancy, and newborn services before and after birth occurs
- Pediatric treatment including vision and oral care (does not apply to adults)
- Mental health services and behavioral treatment like therapy and counseling
- Substance use treatment
- Laboratory services
- Rehabilitative services and devices
- Prescription drugs
- Prescription birth control
- Breastfeeding services
Some plans optionally cover dental, vision, and medical weight management services. However, these are not mandated by the ACA and at the discretion of the insurer.
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