Essential Health Benefits (EHB)
The 10 categories of services all ACA-compliant plans must cover. No annual or lifetime dollar limits allowed on EHB services.
Essential Health Benefits are the 10 categories of services every ACA-compliant non-grandfathered health plan must cover: (1) ambulatory care, (2) emergency services, (3) hospitalization, (4) maternity and newborn care, (5) mental health and substance use disorder services, (6) prescription drugs, (7) rehabilitative and habilitative services, (8) laboratory services, (9) preventive and wellness services, (10) pediatric services including oral and vision care. Annual and lifetime dollar limits on EHBs are prohibited (ACA §2711).
Frequently asked questions
What is essential health benefits (ehb)?
Essential Health Benefits are the 10 categories of services every ACA-compliant non-grandfathered health plan must cover: (1) ambulatory care, (2) emergency services, (3) hospitalization, (4) maternity and newborn care, (5) mental health and substance use disorder services, (6) prescription drugs, (7) rehabilitative and habilitative services, (8) laboratory services, (9) preventive and wellness services, (10) pediatric services including oral and vision care. Annual and lifetime dollar limits on EHBs are prohibited (ACA §2711).
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