What does health insurance cover in USA 2024?

One of the changes the Affordable Care Act (ACA) has implemented in the country’s healthcare system is the standardization of insurance plan benefits. Prior to this, the benefits offered by insurers varied significantly between policies. Currently, US health insurance plans are required to cover a list of 10 “essential health benefits,” consisting of:

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

Dental and eye care coverages for adults are not considered essential benefits but are available as optional add-ons, along with medical management programs. You should also know that long-term care insurance is often separate from health insurance.

Birth control and breastfeeding coverage, meanwhile, are also required benefits.