Essential Health Benefits – What Are They?
by Heather Mosher

Essential Health Benefits – What Are They?

Under the new health care reform law, there are big changes to what is covered on an individual medical plan.  In fact, these changes extend to all health care plans offered in the United States.  You may have already heard this term, but the phrase “Essential Health Benefits” will be common-place starting in 2014. What are the new Essential Health Benefits and what do you have to do to get them?  If you are currently purchasing individual coverage, in most cases you will see your current plan change on January 1st, 2014.

Below are the 10 Essential Health Benefits that all Qualified Health Plans need to cover starting January 1st, 2014.  Going forward, all individuals will be responsible for purchasing a plan that meets the guidelines of a qualified health plan, or face a penalty.

In 2014, Essential Health Benefits found on all Qualified Health Plans will include:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Pediatric services, including oral and vision care
  6. Mental health and substance use disorder services, including behavioral health treatment
  7. Prescription drugs
  8. Rehabilitative and habilitative services and devices
  9. Laboratory services
  10. Preventive and wellness services and chronic disease management

In order to determine which health plan is right for you and your family, contact one of the experienced advisors at VAST.


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