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We've updated one of our most popular materials. See what's new in our guide to MERPs.

Obamacare Essential Health Benefits

Essential Health Benefits and the Affordable Care Act

Obamacare requires that health plans offered in the individual and small group markets, both inside and outside of Health Insurance Marketplaces, offer a core package of items and services, known as "essential health benefits."

What are Essential Health Benefits?Obamacare_essential_health_benefits_affordable_care_act

Essential health benefits are a minimum package of ten items and services that must be covered by all plans in the individual and small group market. This includes health plans offered on the Health Insurance Marketplaces.

The 10 Essential Health Benefits

  1. Ambulatory patient services

  2. Emergency services

  3. Hospitalization

  4. Maternity and newborn care

  5. Mental health and substance use disorder services, including behavioral health treatment

  6. Prescription drugs

  7. Rehabilitative and habilitative services and devices

  8. Laboratory services

  9. Preventive and wellness services and chronic disease management

  10. Pediatric services, including oral and vision care

Affordable Care Act 101 for Small Businesses eBook