What's covered in the Health Insurance Marketplace

What’s covered in the Health Insurance Marketplace

These essential health benefits include at least the following items and services:

  1. Outpatient care—the kind you get without being admitted to a hospital
  2. Trips to the emergency room
  3. Treatment in the hospital for inpatient care
  4. Care before and after your baby is born
  5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
  6. Your prescription drugs
  7. Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
  8. Your lab tests
  9. Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
  10. Pediatric services: This includes dental care and vision care for kids

 

Special Enrollment

In some cases insurance may be available outside of the Open Enrollment period. Special Enrollment Periods (SEPs) allow consumers with specific life changes—such as having a baby, getting married, or losing health insurance–to enroll in a new insurance plan.

A complete list of SEP qualifications, known as Life Changing Events, is listed below.

If you qualify for Medicaid and the Children’s Health Insurance Program (CHIP), you can get health insurance at any time. For more information on these programs