Under the Affordable Care Act, Marketplace plans must provide coverage for the following health benefits:
Additional benefits include birth control and breastfeeding coverage. Some plans may offer additional benefits including adult dental and vision care. Check with your insurer to confirm what your plan offers.
In 2018, the Centers for Medicare and Medicaid finalized a rule allowing states to determine the minimum essential health benefits that individual and small business health plans operating in the state are required to cover, beginning in 2020. This flexibility means that essential health benefits can vary from state to state. In an effort to address the opioid epidemic in our country, Illinois now requires insurers to cover alternative therapies for chronic pain, issue short-term prescriptions for chronic pain and remove barriers to medication-assisted treatment for opioid use disorders. The state also expanded access to mental health services through telepsychiatry.
Specific services may vary based on each state's requirements and you should refer to your insurer and health plan to confirm your exact coverage.
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