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Marketplace coverage & essential health benefits in English 2022


published on July 28, 2022

There are 10 categories of services is called

All private health insurance plans offered in the K Health Insurance Marketplace® must be covered.

What are the 10 essential health benefits?

  • Ambulatory patient services (outpatient care you receive without being admitted to a hospital)
  • emergency services
  • Hospitalization (such as surgery and overnight stays)
  • Pregnancy and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment, counseling and psychotherapy
  • Prescription drugs
  • Rehabilitation and Housing Services and Devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care (does not include adult dental or vision coverage)

What else does Marketplace cover?

Get more information on what Marketplace health insurance plans cover.

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