What does "Essential Health Benefits" refer to?

"Essential Health Benefits" refers specifically to a set of 10 health care service categories that must be covered by plans sold in the Health Insurance Marketplace. This requirement was established under the Affordable Care Act to ensure that all qualified health plans provide a baseline of coverage for essential medical services. These categories typically include services such as outpatient care, emergency services, hospitalization, maternity and newborn care, mental health services, prescription drugs, rehabilitative services, laboratory services, preventive services, and pediatric services.

This designation is crucial because it guarantees that consumers have access to a comprehensive suite of healthcare services, helping to promote health equity and reduce uninsured rates. The inclusion of these essential benefits aims to enhance the overall health outcomes for individuals and families who utilize these insurance plans.