All health insurance plans offered through the U.S. Health Exchange Marketplace will offer the same set of essential health benefits. The U.S. Health Exchange law guarantees that every health plan must meet a minimum set of requirements and must include certain services and benefits.

You may sign up for any of these plans now, but they do not become effective until January 1st 2016. These are services all plans must cover.

The essential benefits and services that all health insurance plans must cover are:

  • Patient ambulatory services (without being admitted to a hospital)
  • Pediatric services
  • Hospitalization (such as surgery)
  • Maternity and newborn care
  • Mental health and substance use disorder services (this includes counseling and psychotherapy)
  • Prescription drugs
  • Emergency services
  • Rehabilitation services and devices (to help individuals with injuries, disabilities, or chronic conditions recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services
Each of these benefits and services will be found in all plans available on the Health Exchange Marketplace. For additional help with narrowing down your search please call the Help-Line at 855-256-8263.



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Learn more about how the Health Insurance Marketplace works, the kinds of plans available, and the four categories of coverage.