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The 10 Essential Health Benefits Covered by Affordable Care Act Policies 

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All Affordable Care Act plans are required to cover these 10
essential health benefits:

Ambulatory patient services (outpatient care you receive without being admitted to a hospital)

Emergency services

Hospitalization (such as surgery or an overnight inpatient stay)

Pregnancy, maternity, and newborn care (both before and after birth)

Mental health and substance abuse disorder services (including counseling and psychotherapy)

Prescription drug coverage

Rehabilitation services and devices (services and devices to help those with injuries, disabilities, or chronic conditions recover their mental and physical abilities)

Laboratory services

Preventive and wellness services (like shots, vaccinations, and screening tests

Pediatric services, including dental and vision care (Note: adult dental and vision are not considered essential benefits but may be available on select plans)

Image by Liv Bruce

Additional Coverage Options

Some plans may also offer additional benefits, including:


  • Dental coverage

  • Vision coverage

  • Medical management programs (for specific needs like weight management, back pain, and diabetes)

  • Chiropractic muscle manipulation

  • Orthotics (shoe inserts)

  • Hearing aids 

  • Acupuncture

Rewards Benefits 

Some ACA plan carriers also offer further benefits such as flex card or cash benefits incentives for following through on things like staying physically active, visiting the doctor regularly, and engaging in preventive services. The specific benefits available to you will depend on a variety of factors, such as where you live.

If you want to learn more about the potential plan benefits available to you, just apply online or call below to speak to a licensed insurance agent about your options.

Image by Khamkhor
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