ACA Essential Health Benefits

All plans offered through Obamacare include essential health benefits. Your insurance must include these benefits or you will pay a tax penalty:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (for surgery and overnight stays)
  • Pregnancy, maternity, and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment ( including counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions to gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services as well as chronic disease management
  • Pediatric services, including oral and vision care (note: adult dental and vision coverage are not essential health benefits)


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