1. The Health Insurance Marketplace: Choosing a Category
  2. Essential Health Benefits for All Plans
  3. Qualifying for Lower Premiums and Out-of-Pocket Expenses
  4. Minimum Essential Coverage & Who Is Exempt
  5. Important Dates to Know

Regardless of whether you choose a Bronze, Silver, Gold or Platinum plan, certain essential health benefits must be covered and your copayments and coinsurance for them count towards your deductible. These services include:

  • Addiction treatment
  • Ambulatory patient services
  • Care for newborns and children
  • Chronic disease treatment (such as diabetes and asthma)
  • Emergency services
  • Hospitalization
  • Laboratory services
  • Maternity care
  • Mental health services
  • Occupational and physical therapy
  • Prescription drugs
  • Preventive and wellness services (such as vaccines and cancer screenings)
  • Speech-language therapy

Tip: These are minimum requirements. Many plans have additional benefits, so it’s important to look at the summary of benefits for any plan that you are considering to make sure it fits your budget and needs.


Qualifying for Lower Premiums and Out-of-Pocket Expenses
Related Articles
  1. Insurance

    Cutting Your Cost for Marketplace Health Insurance

    Here's how you may be able to lower your costs for health insurance coverage in 2016 though the Health Insurance Markerplace.
  2. Insurance

    5 Ways to Ace 2016's Health Insurance Marketplace

    Not sure how the Health Insurance Marketplace/Exchange works? Here are 5 ways to avoid frustration when enrolling through the federal or state exchanges.
  3. Insurance

    3 Reasons To Get High-Premium Health Insurance

    Health insurance is expensive, which is why many people opt for the lowest-premium plan. But that may not always be the cheapest.
  4. Insurance

    Getting The Most From Your Health Insurance Policy

    Don't get stuck with high out-of-pocket costs. Read on to see how you can save your money.
  5. Retirement

    Medicare Part D Is Changing How You Pay for Drugs

    As the price of prescription medication rises and the population ages, insurers are looking for ways to cut costs. That's where coinsurance comes in.
  6. Insurance

    Buying Private Health Insurance

    Getting your own policy isn't easy or cheap but in some cases, it's well worth the effort.
  7. Insurance

    3 Huge Medicare Drug Plan Price Hikes on the Way

    December 7 is the 2017 enrollment deadline for Medicare Part D. Be aware of these price increases – and how to minimize them – before you make a decision.
  8. Insurance

    Is Catastrophic Health Insurance Right for You?

    Catastrophic health plans protect you from high medical costs if you get seriously hurt or injured. But when is catastrophic the best option for you?
  9. Insurance

    4 Ways to Find Good Health Insurance

    Follow these 4 steps to get the best coverage at the most affordable price.
Frequently Asked Questions
  1. When Does a Corporation Decide to Refinance Debt?

    Favorable market conditions or the strengthening of a credit rating may lead to refinancing.
  2. What Is an Odd-Lot Buyback?

    Odd-lot buybacks involve lots of less than 100 shares. Learn how companies get these shares back.
  3. Can I buy a house directly from Fannie Mae (FNMA)?

    Yes, Fannie Mae does sell properties it's foreclosed on; each property is sold in "as is" condition.
  4. What does a merger or acquisition mean for the target company's employees?

    Learn about the likely impact of a merger-and-acquisition deal on the target company's employees, including their benefits ...
Trading Center