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The 10 Essential Health Benefits Covered by Affordable Care Act Policies 


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)

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

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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.

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