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HomeHealthcareSee what’s covered by Marketplace health insurance

See what’s covered by Marketplace health insurance


Published on October 11, 2018

All Marketplace plans cover the same set of essential health benefits, preventive care, and pre-existing conditions. Starting November 1 you can enroll in or renew a plan for 2019, so you’ll continue to have access to these benefits.

What are essential health benefits?

  • Essential health benefits are a set of 10 categories of services — including doctor’s visits, inpatient and outpatient hospital care, prescription drugs, pregnancy and childbirth, mental health, and more — that health insurance plans must cover.
  • Plans must also offer birth control and breastfeeding coverage.
  • These are the minimum requirements for all Marketplace plans. Plans may offer more benefits. You’ll see exactly what’s covered when you compare plans.

What’s preventive care?

  • Most health plans must cover a set of preventive services — like shots and screening tests — at no cost to you.
  • Preventive services are used to prevent illnesses, disease, and other health problems, or to detect illness at an early stage when treatment is likely to work best.
  • These services are free only when delivered by a doctor or other provider in your plan’s network.

What’s coverage for pre-existing conditions?

  • All Marketplace plans must cover treatment for pre-existing medical conditions, like asthma, diabetes, or cancer.
  • Marketplace plans can’t deny you coverage or raise your rates based only on your health.
  • Pregnancy is also covered from the day your plan starts.
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