Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
Under the ACA, 'essential health benefits' (EHB) refers to:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Essential health benefits are the statutorily defined categories of coverage that individual and small-group plans, including qualified health plans, must provide. The categories include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services, laboratory services, preventive services, and pediatric services including oral and vision care. EHB sets a coverage floor for the commercial market.
Why the other options are wrong
- B) EHB is a broad set of coverage categories, not just emergency and catastrophic care.
- C) EHB is mandatory for individual and small-group plans, not a voluntary employer add-on.
- D) EHB governs commercial individual and small-group plans, not Medicare Part A benefits.
Memory hook
EHB = ten coverage categories every individual and small-group plan must carry.