What is the essential health benefits requirement under the ACA?

The essential health benefits requirement under the Affordable Care Act mandates that all health plans sold on the Health Insurance Marketplace must cover a specific set of ten essential health benefits. These benefits ensure that individuals receive coverage for critical areas of health care that are considered necessary for maintaining health and well-being. The ten categories include:

1. Ambulatory patient services (outpatient care)

2. Emergency services

3. Hospitalization (including surgery)

4. Maternity and newborn care

5. Mental health and substance use disorder services

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

By requiring coverage of these essential benefits, the ACA aims to provide a comprehensive health care framework that helps protect consumers from being underinsured and ensures access to necessary health services. This requirement is a key component of the ACA’s goals to improve health insurance standards and expand access to coverage. The other options do not accurately reflect the comprehensive scope of required benefits under the ACA.