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10 covered Marketplace health benefits

Published on June 29, 2023

All private health insurance plans offered in the Health Insurance Marketplaceยฎ must cover the same
. Care in these 10 categories of services is covered by all Marketplace plans.
Icons for a prescription drug bottle, pills, syringe, ambulance, and a heart symbolizing cardiac health on a blue background. Text over the image reads "What's covered? 10 essential health benefits."Icons for a prescription drug bottle, pills, syringe, ambulance, and a heart symbolizing cardiac health on a blue background. Text over the image reads "What's covered? 10 essential health benefits."

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 doesnโ€™t include adult dental or vision coverage)
In addition, plans must also include birth controlย and breastfeeding coverage. Some plans may offer dental and
coverage.
Specific services may vary based on your stateโ€™s requirements. Get more information on what Marketplace health insurance plans cover.