A set of 10 categories of services health insurance plans must cover under the ACA. These include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more.
All plans offered through a marketplace must offer minimum medical coverage and prescription drug benefits, called essential health benefits. Essential health benefits include health care from doctors’ offices and clinics, emergency and overnight care in a hospital, pregnancy and newborn care, mental health services, substance abuse services, prescription drugs, rehabilitative services, laboratory services, preventive/wellness services, and pediatric services. The plans offered in each Marketplace are affordable. Insurance companies must compete on cost and quality and meet certain limits on total cost-sharing.