What are the ACA essential health benefits?

The Affordable Care Act (ACA) defines essential health benefits as a set of health care service categories that must be covered by certain plans. These mandatory services are required in all insurance plans that are compliant with the ACA, ensuring that a baseline level of health care is accessible to individuals and families.

This designation helps to standardize the coverage offered by health plans and ensures that consumers have access to key health services, which include emergency services, maternity and newborn care, mental health and substance use disorder services, prescription drugs, and preventive services, among others. The requirement to include these essential health benefits is aimed at improving health care access and affordability, protecting consumers from inadequate coverage.

Other options suggest aspects such as services excluded from coverage or being only for low-income individuals, which do not align with the ACA’s intent to provide a standardized set of benefits across compliant plans. The focus of the ACA is on comprehensive coverage, reflecting the needs of a broad population, rather than limiting benefits to specific groups or optional services.