What are essential health benefits required in marketplace health plans?

Essential health benefits are a core component of marketplace health plans, specifically defined by the Affordable Care Act (ACA). The correct answer emphasizes a set of 10 required categories of services that these health plans must include. This requirement ensures that individuals purchasing insurance through the marketplace receive comprehensive coverage that meets a standard of care necessary for effective healthcare.

These 10 categories encompass a wide range of services, including but not limited to emergency services, outpatient care, hospitalization, maternity and newborn care, mental health services, prescription drugs, and preventive and wellness services. By establishing these essential health benefits, the ACA aims to protect consumers from inadequate coverage and high out-of-pocket costs, ultimately promoting access to necessary health care services.

In contrast, the other choices discuss services that are either not mandatory or do not reflect the structured requirements set forth by the ACA. Basic services to all policyholders might suggest a broad and undefined array of options that lack the specificity of the mandated categories. Voluntary programs and optional add-ons do not guarantee comprehensive care and depend on the insurer’s discretion, rather than the defined standards that essential health benefits ensure.