Essential Health Benefits

What types of Medical Services are included in the EHBs?

1. Ambulatory patient services: outpatient care, including visits to your primary care doctor, outpatient surgery, dialysis, chemotherapy, and more.
2. Emergency services: Emergency Room visits and emergency transportation.
3. Hospitalization: Inpatient stay in the hospital.
4. Maternity and newborn care: Prenatal and postpartum care and care for the newborn child.
5. Mental health and substance use disorder services: Behavioral health treatment including counseling, psychotherapy, and outpatient and inpatient substance use disorder services.
6. Prescription drugs: Medications including generic, preferred, non-preferred, and specialty drugs, that are prescribed by your doctor.
7. Rehabilitative and habilitative services: Therapies to assist individuals recovering from injury or illness, or receiving treatment for a chronic condition.
8. Diagnostic services: Laboratory and radiology services, such as CT scans,  MRIs, x-rays, colonoscopies and mammograms.
9. Preventive and wellness services: Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.
10. Pediatric services: Services like dental and vision care for children, including routine eye exams, glasses, dental check-ups, and basic dental care. Note that a limit may apply to these services.