10 covered Marketplace health benefits

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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)

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