Return to the Latest

Essential Health Benefits

Basic categories of benefits that must be provided by plans on the new state Health Insurance Marketplaces, individual and small group plans not on the state marketplaces, and state Medicaid plans. These categories of services include: ambulatory services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services; prescriptions; rehabilitative services; laboratory services; preventive and wellness services and chronic disease management; and pediatric services.