What do Affordable Care Act plans have to cover?
Essential Benefits Under the Affordable Care Act

What do Affordable Care Act plans have to cover?

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



Updated: 2020-07-13


All health plans purchased through a state health insurance marketplace must include the following benefits. These are known under the Affordable Care Act as “essential health benefits”:

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

To learn more and find plans available where you live, choose your state or enter your zip code.

Jurisdictional relevance: There are versions of this article for each State.
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