What Are Essential Benefits?

There are some health care benefits you can count on getting no matter what health plan you choose. The Affordable Care Act requires that all health plans cover essential health benefits for individual and family plans and small group plans.

All of our health plans offer these required essential health benefits:

• Outpatient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Behavioral health care, including mental health services and substance use disorder treatment 
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric vision

Some of these benefits, like preventive services, will be paid at 100% with no copay. We'll pay for the other benefits after you meet your deductible. Depending on the health plan you choose, you may still be responsible for paying a copay and coinsurance.