Updated: Jun 16, 2020
The Affordable Care Act made covering certain health care services a requirement for all Health Insurance plans available to consumers. These required services are known as the 10 Essential Benefits. These 10 categories of services are:
Ambulatory patient services (outpatient care that you can receive without being admitted to a hospital)
Emergency Services
Hospitalization for surgery, overnight stays, and other conditions
Pregnancy, maternity, and newborn care
Mental health and substance use disorder services
Prescription Services
Rehabilitative and habilitative services and devices (treatment and devices that help people gain or recover mental and physical skills after an injury, disability, or onset of a chronic condition)
Laboratory services
Preventive and wellness services, as well as chronic disease management
Pediatric services, including dental and vision coverage for children
These are categories of services; the specific services offered within these categories may vary from state to state. For the most part, states require that plans offer more services to their customers, rather than restricting services that an insured would expect within these categories. State, Federal, and private exchanges will list exactly which services each plan covers before you apply for insurance.
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