Which of the following is one of the ten essential health benefit (EHB) categories under the ACA?
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 ten essential health benefit categories include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive and wellness services, and pediatric services including oral and vision care. Hospitalization is therefore an EHB. Non-grandfathered individual and small group plans must cover all ten categories. This definitional point is tested under AH-III.C.3, which defines QHP, guaranteed issue, APTC, and the metal tiers.
Why the other options are wrong
- B) Adult dental care is not an EHB; only pediatric dental is included in the ten categories.
- C) Cosmetic surgery is generally excluded from essential benefits and most plans.
- D) Long-term custodial care is not among the ten EHB categories.
Memory hook
Hospitalization is in the ten; adult dental and cosmetic surgery are out.