There are 10 categories of services — called essential health benefits — that all private health insurance plans offered in the Health Insurance Marketplace® must cover.

What are the 10 essential health 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)

What else does the Marketplace cover?

• Marketplace plans must also offer birth control and breastfeeding coverage.
• Some Marketplace plans may have dental and vision coverage too, but these benefits aren’t required.
• Call your plan to check if it covers a particular service.

Get more information on what Marketplace health insurance plans cover.