Published on June 29, 2023
All private health insurance plans offered in the Health Insurance Marketplace® must cover the same . Care in these 10 categories of services is covered by all Marketplace plans.
10 covered benefits:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment, counseling, and psychotherapy
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (this doesn’t include adult dental or vision coverage)
