Which of the following is one of the ten essential health benefit (EHB) categories that non-grandfathered individual and small group plans must cover?
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 ACA's ten essential health benefit categories are: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. Hospitalization is expressly one of the ten categories, so a non-grandfathered individual or small group plan must cover it as part of its benefit package.
Why the other options are wrong
- B) Cosmetic surgery is not an EHB category; it is generally an excluded, non-essential service under standard medical policies. Cosmetic procedures are not an EHB category and are generally excluded as non-essential.
- C) Long-term custodial care is not an EHB category; custodial care is typically excluded from health policies and is addressed instead by long-term care insurance. Custodial care is outside the ten categories and is handled by long-term care insurance instead.
- D) Vitamins and dietary supplements are not EHB services; they are generally not covered as essential benefits under ACA-compliant plans. Supplements and vitamins are not among the ten categories and are generally not covered.
Memory hook
EHB's big ten: hospitals, doctors, emergencies, babies, minds, drugs, rehab, labs, prevention, kids.