Which of the following is an essential health benefit category that ACA-compliant plans must cover?
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 essential health benefits (EHB) under the ACA include ten categories of care, and hospitalization, or inpatient care, is one of them. Other categories include ambulatory patient services, emergency services, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive services, and pediatric services including oral and vision care. Cosmetic surgery, custodial long-term care, and adult dental implants are not EHB categories, though some plans may offer them as optional benefits.
Why the other options are wrong
- B) Cosmetic surgery is generally excluded from health plans and is not an essential health benefit category under the ACA.
- C) Custodial long-term care is a chronic care service that Medicare and most health plans exclude and is not an EHB category.
- D) Adult dental care, including implants, is optional under the ACA; only limited pediatric dental is an EHB.
Memory hook
EHB covers the big ten: hospital stays, ER, maternity, drugs, and more. Cosmetic and custodial are out.