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Essential Benefits Under the Affordable Care Act

What do Obamacare health insurance plans cover?

All ACA health insurance plans must include certain "essential benefits."

Updated: 2020-07-13 by

All health plans purchased through Access Health CT, the health insurance marketplace for Connecticut, must include the following benefits whether or not you have a pre-existing health condition.

These are known under the Affordable Care Act  as “essential health benefits”:

  1. Ambulatory patient services (meaning outpatient care you receive without being admitted to a hospital)
  2. Emergency services
  3. Hospitalization (including surgery)
  4. Maternity and newborn care
  5. Mental health and substance use disorder services (including counseling and psychotherapy)
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices (for people with injuries, disabilities, or chronic conditions, to strengthen their mental and physical skills)
  8. Lab services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services (including oral and vision care)

Companies that offer plans through Access Health CT will compete on price and quality of service in delivering these benefits.




Connecticut: Law