10 Essential services or coverages that all exchange policies must have

10 essential services that all policies must include if the policy is to be offered on the exchange.

THESE ARE:

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

  • Emergency services

  • Hospitalization (including surgery and overnight stays)

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

  • Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)

  • Prescription drugs

  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)

  • Laboratory services

  • Preventive and wellness services and chronic disease management

  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)