Essential benefits are the ten categories of care that ACA-compliant individual and small-group plans must cover, including hospitalization, prescription drugs, maternity, and mental health. The specific services follow each state’s benchmark plan.
Because EHBs must be covered and the ACA bans health-based pricing and exclusions, people with pre-existing conditions get the same comprehensive coverage at the same rates as everyone else.
EHBs are 10 categories of care that every ACA individual and small-group plan must cover, including hospitalization, prescription drugs, maternity, mental health, and preventive care.