Consumers buying individual or small group health plans will be guaranteed access to 10 “essential” benefits, as part of the Affordable Care Act. This rule, effective Jan. 1, applies to plans both in and out of the online Healthcare Marketplace.
These are not free services; consumers still must pay premiums and associated costs based on the plan they purchase.
1. Emergency services
3. Maternity and newborn care
4. Outpatient medical services
5. Mental health and substance abuse services, including behavioral health
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care
Source: Centers for Medicare & Medicaid Services