Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 1/5
Under the essential health benefits (EHB) rules, adult dental and vision coverage in individual and small-group health plans is generally:
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The essential health benefits categories require limited pediatric dental and vision coverage, but adult dental and vision are generally not mandated — they are commonly offered as optional or standalone coverage. This asymmetry is a recurring exam point: children's dental and vision are built into the essential benefits package, while adults' dental and vision are market products the plan may choose to include or sell separately. The rule flows from the ten EHB categories established under the Affordable Care Act.
Why the other options are wrong
- B) Adult dental and vision are not mandatory at all, and nothing requires them to be provided at no extra premium.
- C) Nothing prohibits adult dental or vision coverage; carriers routinely sell it as optional or separate policies.
- D) The EHB rules apply to individual and small-group plans regardless of employer size; employer size does not make adult dental and vision mandatory.
Memory hook
Kids get dental and vision as essentials; adults get to shop for them a la carte.