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Essential Health Benefits

What Marketplace Health Plans Cover

Under the Affordable Care Act (ACA), individual and small group health plans must cover 10 essential health benefits regardless if the plan is purchased inside or outside of MNsure.

The 10 essential health benefits:

  • Outpatient care you get without being admitted to a hospital, including doctor's office visits
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (examples: physical and occupational therapy, speech-language pathology, psychiatric rehabilitation)
  • Lab tests
  • Preventive and wellness services and chronic disease management (examples: blood pressure and diabetes screenings, mammograms and colonoscopies, vaccinations and flu shots)
  • Pediatric services, including dental and vision care

More information on essential health benefits at HealthCare.gov

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