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Essential Health Benefits

Under the Affordable Care Act, insurance companies must include ten essential health benefits in every plan they offer through state or federal health benefit exchanges, like Vermont Health Connect. Before the Affordable Care Act, some insurance plans didn’t cover these ten benefits, which meant patients had to pay full price for uncovered services.

Now, all plans offered on state or federal health benefit exchanges must cover the ten essential health benefits. If you buy a plan that isn’t certified by the state or federal government, it might not include the ten essential health benefits—so be sure to check. All Vermont Health Connect plans cover the ten essential health benefits.

The ten essential health benefits are:

  • Visits to your healthcare provider’s office
  • Hospital stays
  • Emergency room visits
  • Care for mother and child before, during and after the birth
  • Care for mental health and substance use disorders
  • Prescription drugs
  • Care for children—including vision and dental care
  • Laboratory tests
  • Rehabilitative and habilitative services and devices
  • Preventive services, including vaccines and check-ups