This content is for general informational purposes and does not constitute medical, legal, or financial advice. Healthcare rules and costs change annually. Last reviewed: January 1, 2025. Always verify current details with your insurer, employer, or a licensed healthcare navigator.
Essential Health Benefits (EHBs)
Ten categories of services that ACA-compliant plans must cover.
Full Definition
Essential Health Benefits (EHBs) are ten categories of health services that all ACA-compliant individual and small-group plans must cover. These are: (1) Ambulatory patient services, (2) Emergency services, (3) Hospitalization, (4) Maternity and newborn care, (5) Mental health and substance use disorder services, (6) Prescription drugs, (7) Rehabilitative services and devices, (8) Laboratory services, (9) Preventive and wellness services, (10) Pediatric services including dental and vision. Grandfathered plans and large employer plans are not required to cover all EHBs.
Real-World Example
Before the ACA, many plans did not cover maternity care or mental health treatment. Under the ACA, any compliant individual plan must now cover both — including therapy visits and prenatal care — as Essential Health Benefits.
Related Terms
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