All individual, small-group, and non-grandfathered plans (those that existed after March 23, 2010) must cover the following 10 essential health benefit categories:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive & wellness services & chronic disease management
- Pediatric services including oral and vision care, to age 19
- Mental health and substance use disorder services, including behavioral health treatment