ESSENTIAL HEALTH BENEFITS

Guaranteed Benefits for Every Plan

The Affordable Care Act ensures that all individual health plans offered to consumers, both on and off the Covered California exchange, include a comprehensive package known as essential health benefits. Every health plan must include coverage in these 10 categories at minimum.

The benefits that come standard with every health plan:

Ambulatory Patient Services

Outpatient care—the kind you get without being admitted to a hospital

Emergency Services

Trips to the emergency room

Hospitalization

Treatment in the hospital for inpatient care

Maternity and Newborn Care

Care before and after your baby is born

Mental Health + Substance Abuse Disorder Services

Includes behavioral health treatment, counseling, and psychotherapy

Prescription Drugs

Medicines prescribed to you by a doctor

Rehabilitation

Services and devices that help you recover from an injury or cope with a disability or chronic condition. These include physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.

Laboratory Services

Lab testing services and diagnostic tests ordered by your doctor

Preventative + Wellness Services

Counseling, screenings and vaccines to keep you healthy and manage chronic conditions

Pediatric Services

Medical, dental and vision care for kids

Every family deserves affordable, quality care. Health Marketplace is here to help you get covered.

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